Fewer than one-quarter of the hospitals held monthly meetings with the paramedics who transported heart attack patients, and only 14 percent had a cardiologist on duty at all times, the study found. Having a pharmacist accompany doctors on medical rounds also improved odds of survival, but just 35 percent of the hospitals studied did so.
Still, while these management strategies were associated with improved survival rates, the authors cautioned that the study cannot establish cause and effect.
Speaking on behalf of the American Heart Association, Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "owing to advances in care and performance improvement programs, there have been significant improvements in survival in patients presenting with an acute heart attack."
Nevertheless, there appear to be substantial opportunities to further improve outcomes of these patients, he said.
In this study, certain strategies were found to have statistically significant but small associations with differences in 30-day mortality.
"Additional efforts are needed to implement evidence-based, guideline-recommended therapies in all eligible acute heart attack patients and further promote effective strategies, performance improvement programs and systems of care," Fonarow said.
The American Heart Association and the American College of Cardiology together with the American Heart Association offer highly effective guidelines for hospitals that want to improve care of heart attack patients, he said.
For more information on heart attacks, visit the U.S. Heart, Lung, and Blood Institute.
SOURCES: Elizabeth H. Bradley, Ph.D,
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