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Specialized System Speeds Heart Attack Treatment
Date:1/16/2008

Patients got arteries open faster with program established in Ottawa, Canada

WEDNESDAY, Jan. 16 (HealthDay News) -- A citywide system in Ottawa, Canada, designed to rush heart attack patients to a specialized center for artery-opening treatment dramatically cut the time it took to perform the potentially lifesaving procedure, cardiologists report.

The procedure is balloon angioplasty, in which a balloon is threaded into a blood vessel and inflated to restore flow in a coronary vessel blocked by a clot. The American Heart Association has set a goal of no more than 90 minutes from diagnosis of a heart attack to angioplasty. And that goal was met for almost 80 percent of the cases handled by specially trained paramedics, according to a report in the Jan. 17 issue of the New England Journal of Medicine.

"We have developed a system in which the paramedics do an ECG [electrocardiogram] in the field," said Dr. Michel R. Le May, professor of medicine at the University of Ottawa Heart Institute, and lead author of the report. "They call through a dedicated cell phone line to the Heart Institute to notify the STEMI team that they are arriving. Then, they go straight to the catheter lab."

STEMI stands for ST-segment elevation myocardial infarction, the deadliest kind of heart attack, and the catheter lab is where angioplasty is done.

The average "door-to-balloon time" for the 135 heart attack patients handled by that specialized system for the year beginning May 1, 2005, was 69 minutes. By contrast, time to treatment for the 209 patients sent from emergency rooms was 123 minutes.

That produced a difference in survival numbers, with six deaths in the following six months for people treated through the paramedic system (4.4 percent), compared to 12 deaths (5.7 percent) for those who went through emergency rooms. The survival figures should be regarded cautiously, Le May said, in part because the numbe
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