Emergency Angioplasty Alone Works
Study finds procedure effective without surgical backup
SUNDAY, Nov. 17, 2002 (HealthDayNews) -- People who receive emergency angioplasty for heart attacks have the same survival rates whether or not there's cardiac surgery backup.
That's the finding of a study presented today at the American Heart Association's scientific sessions meeting in Chicago.
The American study is the largest to date showing the benefit of immediate angioplasty in people with heart attacks.
Researchers examined data on 30,358 people from more than 700 hospitals contained in the National Registry of Myocardial Infarction. It's one of the largest observational studies on heart attack and includes data on more than 1.8 million American heart attack patients.
In this new study, the researchers looked at the results for 1,935 people with heart attack who were taken to 97 hospitals that performed angioplasty or diagnostic catheterization but didn't have cardiac surgical units. They compared that to 28,603 people with heart attack who received angioplasty at 562 hospitals with cardiac surgical units.
The study found the in-hospital death rates were 3.2 percent at hospitals with diagnostic catheterization but no cardiac surgery, 4.4 percent at hospitals with angioplasty but no cardiac surgery, and 5 percent at hospitals with angioplasty and on-site cardiac surgery.
In the last group, patient death rates ranged from 4.8 percent for people treated in-house to 6.5 percent for people transferred from another facility.
The study also found a significant difference in the time that elapsed between the heart attack victims' arrival at hospital and when they received angioplasty.
If a person was transferred from one facility to another, the average wait for angioplasty was 198 minutes. That compares to 107 minutes in hospitals performing angioplasty with or without on-site cardiac surgery and 96 minutes at hospitals performing diagnostic catheterization without cardiac surgical units.
The authors say the findings show that hospitals with diagnostic laboratories that meet American Heart Association/American College of Cardiology criteria for doing emergency angioplasty without on-site cardiac surgical units should do the lifesaving procedures instead of transferring heart attack patients to hospitals with cardiac surgery units.
The Mayo Clinic has more about angioplasty.