Heart Attack Centres Offer Best Treatment For Patients, UK
Harefield Hospital consultant cardiologist Dr Miles Dalby and his colleagues compared the outcome of 180 patients who received direct primary angioplasty at Harefield Hospital in Middlesex to the outcome of 181 patients who received the thrombolysis treatment at district general hospitals in the preceding two years. The results showed that direct primary angioplasty with rapid arrival-to-treatment times had a significantly higher survival rate than thrombolysis.
Dalby explains: "Patients who were taken directly to Harefield Hospital by paramedics for primary angioplasty had a very low 30-day mortality rate of less than 3 per cent. This shows a very large and significant mortality benefit when compared to patients who received thrombolysis treatment. That patient group had a mortality rate of 9 per cent."
The research highlighted the need for rapid treatment, showing that while a less than 3 per cent, 30-day mortality rate for primary angioplasty was achieved when patients were taken directly to Harefield by ambulance, those who went to district general hospitals first and were later transferred to Harefield for primary angioplasty had a much higher mortality rate.
Dalby says that prompt treatment is the essence of an effective primary angioplasty service and requires an exceptionally high level of commitment from the whole team: "During a heart attack, blood flow to the heart muscle is blocked which damages it. The sooner the patient receives treatment enabling the blood flow to return to the coronary arteries, the less damage occurs. This gives better long-term results - time is muscle."
Dalby continues: "We carried out nearly 300 emergency primary angioplasties with an average time of 24 minutes from when patients arrived at the Harefield to having the procedure and restoring blood flow to the heart. This makes our primary angioplasty service one of the fastest in the world."
For the past three years, Harefield Hospital has offered North West London residents fast access to specialist emergency care at the 24-hour 'Heart Attack Centre'. Paramedics from the London Ambulance Service have undergone specialist training to identify patients whose lives could be saved by being transferred directly to Harefield. The ambulances are met by a specialist cardiology team and the patient is taken directly to the catheter labs, where primary angioplasty is carried out immediately.
Royal Brompton & Harefield NHS Trust is a centre for excellence in the research, diagnosis and treatment of heart and lung disease. It is a national and international referral centre for patients of all ages. http://www3.rbht.nhs.uk/
Primary Angioplasty
Cardiologists perform primary angioplasty to clear blockages in the heart's arteries and limit the attack. A thin tube (catheter) is passed along an artery in the patient's leg to their heart. The blocked coronary artery is cleared with a wire and a small balloon. A small metal tube (stent) is placed to keep the artery open. In many accident and emergency departments, a drug-based, clot-busting treatment called thrombolysis is used.
British Cardiovascular Society's Annual Scientific Conference
4-7 June 2007
Glasgow SECC
For full details on the conference, visit: http://www.bcs.com
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