Improved Treatments Reduce Heart Attack Deaths, Study Finds

Greater use of angioplasty and new drug treatments over the past several years has contributed to a nearly 50% decrease in the number of hospitalized heart attack patients who die or develop severe heart failure, according to a study published on Wednesday in the Journal of the American Medical Association, the Los Angeles Times reports.

For the study, researchers examined 44,372 patients in 113 hospitals in 14 countries from 1999 to 2006. All participants had experienced a severe heart attack or acute coronary syndrome, which includes other types of heart attacks and unstable angina (Maugh, Los Angeles Times, 5/2).

Study participants came from the U.S., Canada, Europe and South America (Sternberg, USA Today, 5/2). The researchers found that 4.6% of heart attack patients died in hospitals in 2005, compared with 8.4% in 1999.

Heart failure developed in 11% of heart attack patients in 2005, compared with about 20% in 1999. In addition, the researchers found that 2% of participants had subsequent heart attacks in 2005, compared with 4.8% in 1999.

The study noted that the improvements likely were a "direct consequence" of guidelines put in place by heart organizations in the U.S. and Europe (Tanner, AP/Philadelphia Inquirer, 5/2). Those guidelines recommend the use of angioplasty and the administration of certain drugs, including aspirin, statins, anti-clotting drugs, blood thinners such as clopidogrel and heparin, and blood pressure drugs such as ACE inhibitors (Los Angeles Times, 5/2).

Use of these treatments "climbed during the study and in some cases more than doubled," the AP/Inquirer reports.

The study found that 85% of heart patients received cholesterol drugs in 2005, compared with 37% in 1999. Researchers also found that 78% of participants received blood thinners in 2005, compared with 30% in 1999. In addition, 53% of heart patients had quick angioplasties in 2005, compared with 16% in 1999.

The study was funded by Sanofi-Aventis, whose heart drugs include Plavix and ACE inhibitors (AP/Philadelphia Inquirer, 5/2).

The researchers could not attribute the improvements to any particular treatment or medication and concluded that the results likely were due to a combination of factors (Los Angeles Times, 5/2).

Lead study author Keith Fox, a cardiology professor at the University of Edinburgh in Scotland, said, "These results are really dramatic because, in fact, they're the first time anybody has demonstrated a reduction in the development of new heart failure." Fox added, "It's much more dramatic than we expected, in the course of six years."

Steven Nissen, former president of the American College of Cardiology and a Cleveland Clinic heart specialist, said, "I really am encouraged that those things that appear in our guidelines are being used by physicians around the world" (AP/Philadelphia Inquirer, 5/2).

Sidney Smith, a spokesperson for the American Heart Association, said that the findings are "exactly what we would hope would happen from the major guideline efforts in this area over the past decade." Smith added, "The tragedy is that too many people delay before coming to the hospital and thus do not benefit from the therapy" (USA Today, 5/2).

Another study published in the American Heart Journal on Wednesday found similar improved treatment of heart failure.

For the study, led by Gregg Fonarow of UCLA's David Geffen School of Medicine, researchers studied 159,168 patients in U.S. hospitals. The researchers found that from 2002 to 2004, there was a 29% reduction in deaths while patients were in hospitals and a 36% decline in the need for mechanical ventilation.

The researchers also found a reduction in the length of stay in the intensive care unit and in the hospital overall. The researchers concluded that improvements were the result of an increased use of oral beta blockers.

The study was funded by biopharmaceutical company Scios (Los Angeles Times, 5/2).