Emergency angioplasty OK without surgical back-up

CHICAGO, Nov. 17 Survival rates following emergency angioplasty for heart attack are the same regardless of the availability of on-site cardiac surgery, according to research reported today at the American Heart Association's Scientific Sessions 2002.

"This is the largest study to date demonstrating the benefit of immediate angioplasty in acute heart attack patients," says lead researcher Timothy A. Sanborn, M.D., chief of the division of cardiology at Evanston Northwestern Healthcare, in Evanston, Ill.

Data on 30,358 patients eligible for percutaneous coronary intervention (PCI, also known as angioplasty) at more than 700 hospitals were collected from the National Registry of Myocardial Infarction (NRMI).

The NRMI is one of the largest observational studies of acute myocardial infarction (heart attack). It includes data on more than 1.8 million heart attack patients in the United States.

"The implications are significant. Hospitals with diagnostic laboratories that meet American Heart Association/American College of Cardiology criteria for performing emergency angioplasty without on-site surgery should perform these life-saving procedures rather than transfer patients to another facility with on-site surgery," says Sanborn, who is also co-director of Evanston Northwestern's Cardiovascular Care Center and a professor of medicine at Northwestern University.

Researchers examined in-hospital death rates and elapsed time from hospital door to angioplasty procedure for 1,935 patients at 97 facilities without cardiac surgical units where diagnostic catheterization or PCI procedures were performed electively. The data were compared with those for 28,603 patients treated at 562 hospitals performing elective PCI with on-site cardiac surgery units.

In-hospital death rates were 3.2 percent at facilities with diagnostic catheterization but no cardiac surgery, 4.4 percent at hospitals with PCI but no on-site surgery, and 5.0 percent at hospitals

Contact: Carole Bullock
American Heart Association

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