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Deaths From Heart Attack Rise With Delays in Care
Date:8/18/2010

mary percutaneous coronary intervention (PCI), also known as balloon angioplasty, in which a catheter is threaded into the artery and a balloon at the end is inflated to help widen it. Usually, when the tube is removed, a stent, or wire mesh structure, is left behind to prevent the artery from narrowing again.

All the patients were treated within 12 hours by PCI, and 2 percent of them were pretreated with clot-busting drugs to restore blood flow.

In Denmark, PCI became the recommended treatment for STEMI heart attacks in 2003, according to the study. Research shows that PCI is more effective than older treatments, such as clot-dissolving medications, Terkelsen said.

But in the United States, not every hospital is equipped to do PCI, said Dr. Christopher Granger, director of the cardiac care unit at Duke University Medical Center.

Even hospitals that do offer PCI don't necessarily have the medical staff on hand 24-7 to get it done quickly, Granger said.

That makes it critical to get to the right sort of hospital -- one that has a "catheterization lab" in which staff can be activated quickly when a STEMI patient is on route, Granger said.

A key step in activating the "cath lab" is making sure that paramedics can diagnosis the heart attack en route, Granger said. To do this, ambulances need to be equipped with 12-lead electrocardiogram (ECG) machines, which can diagnosis the telltale signs of STEMI.

While all ambulances in Denmark have 12-lead electrocardiogram, the same can't be said of all U.S. ambulances, Granger said.

Even when STEMI is diagnosed by first responders, it is not ideal to rush a patient to a hospital that doesn't offer PCI.

"The time from the 911 call until the artery is opened is a very powerful, independent predictor of long-term survival," Granger said. "The faster you get to a hospital that has the ability to PCI, the better your chances of living."

About 400,000 people in the Uni
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