Navigation Links
New Heart Attack Treatment Guidelines Stress Coordination

Getting patients to the right hospitals quickly is critical, experts say

WEDNESDAY, Nov. 18 (HealthDay News) -- There's a message for doctors, hospitals and communities in new guidelines for treatment of coronary disease and heart attacks: Get organized.

Every community should have an organized system of emergency care for heart attacks, including programs to identify patients before they get to hospitals and strategies for getting them to medical centers equipped to perform artery-opening procedures, say the guidelines issued by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.

"The focus on integrated systems for patients with STEMI is important," said Dr. Sidney C. Smith Jr., a professor of medicine at the University of North Carolina, a past president of the American Heart Association and co-chair of the group that wrote the guidelines. "It affects a large number of the population that have heart attacks and will improve their treatment for sure."

STEMI is an acronym derived from the pattern seen on an electrocardiogram in the most severe form of heart attacks. The goal is to get a heart attack victim as quickly as possible to a medical center for what is formally called percutaneous coronary intervention (PCI) -- insertion of a balloon-tipped catheter into a blocked heart artery to reopen the blood vessel, usually followed by implantation of a stent, a thin tube, to be sure it remains open.

"The general recommendation is to move a patient if at all possible directly to hospitals where they are able to do immediate angioplasty [PCI]," said Dr. Spencer B. King III, president of the St. Joseph's Heart and Vascular Institute in Atlanta, a past president of the American College of Cardiology and co-chair of the guidelines group. "If that is not possible, then there should be very rapid transport to hospitals that do angioplasty."

The guidelines include recommendations on changes in treatment of heart attacks and coronary disease based on new research findings. For example, stenting now is recommended in many cases where the left main coronary artery, which provides blood to the majority of the heart, is blocked.

"It was previously thought not advisable to do it, but to go directly to bypass surgery," King said. "But evidence continues to build that for some patients with left main blockage, stenting should be considered."

Several studies, notably one from Korea, found similar outcomes for stenting or surgery in treating left main artery blockage, King said.

Other technical issues covered by the guidelines include:

  • Recommendations on use of a powerful new clot-dissolving drug, prasugrel (Effient), as an alternative to clopidogrel (Plavix), commonly prescribed after PCI. The greater ability of the new drug to dissolve clots does carry an added danger of excessive bleeding.
  • Use of a wire threaded into the coronary artery to gauge whether build-up of plaque deposits are great enough to warrant PCI.
  • Use of aspiration thrombectomy, in which the clot causing a heart attack is sucked out before a stent is implanted.
  • Recommendations on use of blood thinners and clot-dissolvers before, during or after PCI.
  • Recommendations on the types of X-ray dye used to view the heart arteries during PCI in patients with chronic kidney disease.

"But the big recommendation is that we need to improve the system of how patients get into one hospital when they are having a heart attack and then get into another hospital, if necessary," Smith said.

The guidelines will be published in the Dec. 1 issues of the Journal of the American College of Cardiology and Circulation, and the Nov. 18 issue of Catheterization and Cardiovascular Interventions.

More information

Heart attacks and their treatment are explained by the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Sidney C. Smith Jr., M.D., professor, medicine, University of North Carolina, Chapel Hill; Spencer B. King III, M.D., president, St. Joseph's Heart and Vascular Institute, Atlanta; Dec. 1, 2009, Journal of the American College of Cardiology; Dec. 1, 2009, Circulation; Nov. 18, 2009, Catheterization and Cardiovascular Interventions

Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Terumo Heart, Inc. Wins Top Healthcare Category Honors at's 5th Annual ‘Deals Of The Year' Award Ceremony
2. Study Reveals Evidence of Heart Disease in Ancient Egyptian Mummies
3. American College of Cardiology/American Heart Association Comment on the FDA Public Health Advisory Regarding a Drug Interaction Between Clopidogrel and Omeprazole
4. Your own stem cells can treat heart disease
5. Obesity Rolling Back Gains in Heart Health
6. The Mummies Curse: Heart Disease
7. Heartburn Drugs Can Thwart Popular Blood Thinner
8. Highlights of NHLBI-supported research presented at American Heart Associations Scientific Sessions
9. Newer heart devices significantly improve survival, complication rate and quality of life
10. Pitt part of $100 million NHLBI Bench to Bassinet effort in congenital heart disease
11. Moderate-Fat Diet May Be Better at Reducing Heart Risks
Post Your Comments:
(Date:11/24/2015)... , ... November 24, 2015 , ... Dr. Todd S. ... offer laser services to many of his patients. Dr. Afferica now uses the BIOLASE ... reduce the amount of time the doctor uses other traditional cutting tools, such as ...
(Date:11/24/2015)... ... November 24, 2015 , ... Young patients with a wide variety of dental ... Dr. Kedar S. Lele, who are pediatric dentists in Tucson, AZ . Unlike ... iPlus 2.0™ system causes minimal discomfort and bleeding to the patient during treatment and ...
(Date:11/24/2015)... ... November 24, 2015 , ... ... Black Friday sale a week early, offering 40% off select bras and underwear ... apparel industry through both mobile fit technology and the latest fashion, quickly becoming ...
(Date:11/24/2015)... ... November 25, 2015 , ... Catalent Pharma Solutions, the leading ... health and global clinical supply services, today announced that Dr. Christine Milligan, Global ... Asia Conference, to be held at the InterContinental Seoul COEX Hotel, Seoul, Republic ...
(Date:11/24/2015)... ... 2015 , ... The hospitals and health systems on this ... care. They have received recognition for excellence from various reputable organizations in areas ... Hospital Review selected hospitals for inclusion based on national rankings and awards from ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... -- iRhythm Technologies, Inc. , a leading digital health care ... will participate in the 27th Annual Piper Jaffray Healthcare Conference at ... . Kevin King , Chief Executive Officer of ... 8:50am ET. --> --> ... . --> iRhythm is a privately held ...
(Date:11/24/2015)... Mass. , Nov. 24, 2015  Boston Scientific ... in the Oppenheimer 26th Annual Healthcare Conference on December ... Susie Lisa , vice president, Investor Relations, ... host analyst beginning at approximately 8:35 a.m. ET. ... will participate in a 30-minute question-and-answer session with the ...
(Date:11/24/2015)... , Nov. 24, 2015  BioPlast Manufacturing, ... the medical research, clinical diagnostic and biotech environments, ... leading manufacturer of quality petri dishes. This acquisition ... clients a platform of products that are designed ... with the highest quality.  ...
Breaking Medicine Technology: