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Trial Shows Heart Attack Education Makes Little Difference
Date:10/7/2009

eeded, Riegel said, and some changes might be made in the education program. "We'd like to do a study with a more powerful intervention," she said. "The one booster call a month later might not be strong enough to alter the response time."

Plans for such a study already are being made, with hopes for government funding. And meanwhile, Riegel said, the trial was not a total loss. "We've learned a ton from this one," she said.

The heart attack symptom that everyone knows is discomfort and/or pain in the chest that lasts for a few minutes or recurs. Other symptoms can include discomfort in the upper part of the body, perhaps affecting the arms, the back or the jaw; shortness of breath, with or without chest pain; a cold sweat, nausea or lightheadedness. A 911 call for emergency medical service or a quick trip to a hospital emergency room is recommended when those symptoms occur, with artery-clearing treatment most effective when started within 90 minutes of onset.

There were glimmers of hope in the results. Response times in the education group were shorter in the first six months after the education session, and people in the education group were more likely to take aspirin, which helps prevent artery-blocking blood clots, when they felt chest pain or had other heart attack symptoms.

But the trial's disappointing results might have been influenced by another possible mistake, which was downplaying the dangers of a delayed response during the education phase of the trial, said study leader Kathleen Dracup, dean of the school of nursing at the University of California, San Francisco.

"We assured patients about the interventions that would reverse the [heart attack] process," Dracup said. "We emphasized the positives about seeking help early, and didn't focus on what happens when you don't seek help early. We wanted to reassure patients that the health-care system would take care of them, when in reality the dangers can a
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