Heart Attack Deaths in Hospitals Go Down- Study

The number of deaths from severe heart attacks after hospital admission has nearly halved in six years, most probably because of better emergency treatment, and newer drugs, a new study by British researchers finds.

Reporting Wednesday in the Journal of the American Medical Association (JAMA), a team of the international researchers said that in just six years, death rates and heart failure in hospitalized heart attack patients have fallen sharply, revealing that the death rates declined from 8.4% to 4.5% between 1999 and 2005.

Even, the long-term health impact of attacks also went down dramatically, most likely due to medical advances, the largest international study of its kind showed.

To validate their findings, the researchers studied 44,372 patients admitted to 113 hospitals in 14 countries with major heart attacks or dangerous partial artery blockages. Patients for the study were enrolled between July 1999 and December 2005 and were followed for up to six months after hospitalization.

Besides the United States, they were hospitalized in Argentina, Australia, Austria, Belgium, Brazil, Canada, France, Germany, Italy, New Zealand, Poland, Spain and the United Kingdom.

In their six-year study, researchers found that the percentage of patients who died in the hospital or who developed heart failure was nearly cut in half. The study revealed that in 2005, 4.6 percent of the heart attack patients died in the hospital, compared with 8.4 percent in 1999.

It also showed their risk of new heart failure nearly halved with a reduction from 20% to 11%. That means for every 1000 patients entering hospital there were 39 fewer deaths and 90 fewer patients with new heart failure. In addition, just 2 percent had subsequent heart attacks in 2005, compared to 4.8 percent previously.

“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,” said lead author Dr. Keith Fox, a cardiology professor at the University of Edinburgh. "Many programmes have tried to prevent new heart failure. This is the first large-scale programme that has really shown that in patients."

Besides the fall in death rates for severe heart attacks, where the arteries were completely blocked, improved outcomes also were found in those with partial blockages, which include less severe heart attacks. Deaths from milder attacks were reduced from 2.9% to 2%. Both patients with severe and milder heart attacks were less likely to suffer from strokes and further heart attacks in the following months.

Treatments such as angioplasty to unblock arteries and anti-clotting drugs played the major role in decreasing cardiovascular attacks, the researchers said. They further added that these significant improvements are probably a “direct consequence” of new practices that followed updated guidelines from key organizations of heart experts in the United States and Europe.

Recommendations in those guidelines include immediate use of aspirin or more potent blood thinners; beta blockers to reduce the damaged heart's oxygen needs, statins to lower cholesterol; ACE inhibitors to relax blood vessels; and angioplasty to open blocked vessels soon after hospitalization.

Although, it was already known that these treatments were effective, but, Professor Fox said "Our study supports the fact that hospitals are using new treatments effectively,” concluding that better hospital treatment and new drugs are all helping to reduce the rate of patients dying from heart attacks.

"Patients now have a much reduced risk of dying or having another stroke while being treated in hospital and are also less likely to suffer a stroke or further heart attack once they have been discharged," he added.

In US alone, an estimated 71 million people have one or more forms of cardiovascular disease, and most of the Americans die from the heart disease, as per the information provided by the Robert Wood Johnson Foundation.

The International study, which is the result of work of a team at Edinburgh University began with hospitals in Scotland and a number of other countries in 1999, was funded by a grant from Sanofi-Aventis, maker of several heart drugs including Plavix and ACE inhibitors.