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Statewide program helps improve quality of care for heart attack
Date:11/4/2007

Implementation of a program in North Carolina to increase the rate of coronary reperfusion (restoring blood flow to the heart muscle) for heart attack significantly improved the quality of care these patients received, according to a study in JAMA being released early online to coincide with its release at the American Heart Associations annual meeting. The study will be published in the November 28 print issue of JAMA.

ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram during a heart attack) is a potentially lethal condition for which specific therapies, administered rapidly, can reduce the risk of death and illness. Despite more than two decades of clinical trial evidence demonstrating significant benefits from prompt coronary reperfusion, registries continue to show that most patients are still treated too slowly for reperfusion to be of maximal benefit, and many are not treated at all, according to background information in the article. The reasons for this are largely related to systematic barriers.

James G. Jollis, M.D., of Duke University, Durham, N.C., and colleagues conducted a study to determine if establishment of a coordinated statewide system of reperfusion therapy for STEMI (Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments [RACE] study), as exists for trauma, would overcome systematic barriers and both decrease delays in administering reperfusion therapy and increase the frequency with which reperfusion was provided to eligible patients. The researchers focused on the coordination of each aspect of care from the initial emergency medical response to reperfusion itself, whether is was fibrinolytic therapy (medication for dissolving blood clots) or primary percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open blocked coronary arteries), whichever was most appropriate for a given setting.

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Contact: Michelle Gailiun
919-724-5343
JAMA and Archives Journals
Source:Eurekalert

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