angioplasty as an emergency or secondary treatment to reopen blockages increased by more than 30 percent in STEMI patients and around 20 percent in ACS patients.
As the use of all these treatments increased, the death rate for patients both in the hospital and in their first six months after going home decreased significantly. So did the risk that patients would develop heart failure, have pulmonary edema, or suffer a stroke in their first six months after hospitalization.
"These findings are exciting because they provide good evidence that improved use of guideline- based treatments has resulted in fewer deaths and fewer patients with heart failure in those that present to hospital with heart attack or threatened heart attack," says Keith A. A. Fox, MB. ChB., FRCP, lead author of the paper, co-chair of GRACE and a professor of cardiology at Edinburgh.
"These data are extremely encouraging, and suggest that we're definitely improving heart care and patients' outcomes through the uniform use of evidence-based, proven treatments and the development of guidelines to help providers understand the evidence behind them," says Kim Eagle, M.D., FACC, a co-author on the paper and co-chair of the publication committee for GRACE. He is the Albion Walter Hewlett Professor of Cardiovascular Medicine at the U-M Medical School and a director of the U-M Cardiovascular Center.
"Yet, these data and other studies show that we still have a ways to go before every heart attack and ACS patient receives the full range of tests and treatments that we know can benefit them," Eagle continues. He notes, for example, that only 85 percent of STEMI patients and 83 percent of ACS patients in the study received a statin in 2006, when virtually all such patients should receive the cholesterol-lowering drug. And only 53 percent of STEMI patients received emergency angioplasty, when it has repeatedly been shown to be life-saving in such patients.
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