It's never too late to 'hurry up' angioplasty treatment

(BETHESDA, MD) Slicing minutes off the time it takes hospitals to deliver emergency angioplasty (the "door-to-balloon" time) improves the survival of appropriate heart attack patients, even when patients have been feeling symptoms for a few hours, according to a new study in the June 6, 2006, issue of the Journal of the American College of Cardiology.

"There is a belief among some clinicians that patients presenting late will not benefit from faster door-to-balloon time (a "cow is already out of the barn" philosophy). We were able to show that door-to-balloon time matters for all patients regardless of time to presentation. Furthermore, we were able to show that door-to-balloon time mattered for both low and high risk patients. In summary, all patients can benefit from shorter door-to-balloon times," said Robert L. McNamara, M.D., M.H.S. from the Yale University School of Medicine in New Haven, Connecticut.

Dr. McNamara noted that it is already well-documented and widely accepted that patients benefit from reducing the overall time between the onset of heart attack symptoms and effective treatment to restore blood flow in coronary arteries. As a result, most hospitals have taken steps to reduce the amount of time it takes to diagnose patients arriving through their emergency departments, activate treatment teams, and begin angioplasty procedures.

However, when patients have been feeling symptoms for a few hours before reaching the hospital, it has not been as clear whether zipping them from the emergency department into a catheterization lab still improves survival.

The researchers used data from a national registry in which hospitals voluntarily enter information about heart attack patients they have treated. The National Registry of Myocardial Infarction (NRMI) is sponsored by Genentech Inc. of South San Francisco, California. In particular, they looked at data on 29,222 heart attack patients treated with angioplasty (percutaneous

Contact: Amy Murphy
American College of Cardiology

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