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Study Finds Timing Is Everything For Some Heart Attack Patients
Date:11/11/2008

to study the ideal timing for intervention," he said, adding that an earlier trial on the issue was too small to provide a conclusive answer.

"Randomized trials have shown the benefit of coronary artery bypass grafting and percutaneous coronary intervention (PCI) in patients with this form of acute coronary syndrome (ACS), however the optimal timing of those interventions is unknown," he said.

A heart attack occurs when the blood supply to part of the heart through a coronary artery is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle are blocked. This is usually caused by the buildup of plaque (deposits of fat-like substances), a process called atherosclerosis. The plaque can eventually fracture, creating a place where a blood clot forms and blocks the artery, leading to a heart attack.

When most people think of heart attack they think of ST-elevation myocardial infarction (STEMI), an emergency situation in which the patient has a complete blockage in an artery. Those patients usually should get clot-busting drugs, balloon angioplasty or bypass surgery within minutes or hours of symptom onset.

"Non-ST-elevation myocardial infarction (non-STEMI) patients have less than a complete blockage and their chest pain tends to subside in response to initial medical treatment. Therefore, unlike STEMI, there is no imperative to proceed rapidly to the cath (catheterization) lab. In fact, some have hypothesized that it may be harmful to do so, because if the patient needs a PCI, the procedure would be performed on a recently ruptured plaque with a fresh thrombus (blood clot). The thought was that those conditions could lead to increased complications and higher event rates," he said.

However, several studies comparing STEMI and non-STEMI heart attacks have found that STEMI patients tend to fare better, leading to the hypothesis that the timing of treatmen
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SOURCE American Heart Association
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