Why Survival Rates After Heart Attacks Have Improved
Researchers were surprised to learn how much treatments that open narrowed or blocked coronary arteries can improve survival.
Researchers looking at data of nearly 400,000 patients in England and Wales wanted to know why death rates after a certain type of heart attack fell by nearly half over 10 years.
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Their surprising finding: Increased use of treatments that opened the patients’ narrowed or blocked coronary arteries had a strong association with the improved survival rates.
The results of the study, published online Tuesday in Journal of the American Medical Association, also showed that patients’ medical history, risk or increased use of medicines had less of an impact on survival rates.
The study, by researchers at University of Leeds in England, looked at data from 400,000 patients with a less severe type of heart attack called NSTEMI. The patients were from nearly 250 hospitals in England and Wales.
The authors note that their findings should not be interpreted to say that medications have no role in treating NSTEMI heart attacks. They say their study results showed that treatments such as aspirin, beta-blockers and statins each had a significant association with improved survival.
A heart attack occurs when an artery supplying blood to the heart suddenly becomes blocked. All or part of the heart muscle becomes cut off from its oxygen supply. The heart muscle becomes injured due to the lack of oxygen.
Cardiologists have a saying: Time is muscle, says preventive cardiologist Haitham Ahmed, MD, MPH. That means the more quickly physicians can treat a heart attack with a procedure such as angioplasty or stents, the better a patient’s chance for survival.
“At the same time, physicians have been able to do this procedure more safely and to open up blocked arteries faster,” Dr. Ahmed says. “So this has translated into better cardiovascular outcomes.”
Hospitals and health centers with deep experience in doing these types of procedures tend to have better outcomes too, Dr. Ahmed says.
“This study dramatically illustrates that these procedures have helped our patients to live longer,” Dr. Ahmed says
Follow-up studies will be needed because the study only shows a link between improved survival rates and these treatment procedures, Dr. Ahmed says. Other variables could have contributed that are not captured in this study, he says.
“So we don’t know for a fact if it’s the actual procedure or not, but the study was pretty comprehensive and suggests it with high confidence,” he says.
Survival rates following a heart attack have improved globally in recent years. This study helps support the view that in many ways, coronary disease is no longer the lethal diagnosis that it used to be 20 or 30 years ago, Dr. Ahmed says.
“For many people, coronary disease is now a chronic disease,” Dr. Ahmed says.