Systems treating severe heart attacks expanding nationwide

May 22, 2012, American Heart Association

The number of systems of care that quickly transfer and treat heart attack patients has increased substantially across the nation, according to research published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Results of a from the American Heart Association's Mission: Lifeline® STEMI program found similar characteristics and challenges with regional care systems that treat patients with ST-segment elevation myocardial infarction (STEMI), the most severe form of heart attack.

Each year in the United States, nearly 300,000 people have a STEMI, which occurs when a blood clot completely blocks an artery to the heart. To prevent death, it's critical to immediately restore blood flow, either by surgically opening the blocked vessel or by giving clot-busting medication.

Ideally, the initial 9-1-1 call activates the STEMI system when someone suffers a heart attack. The continuum includes the care patients receive in route to and at hospitals.

Between April 2008 and January 2010, 381 STEMI-care systems, representing 899 hospitals in 47 states, responded to the Mission: Lifeline survey. Systems included at least one hospital that performs the artery-opening procedure percutaneous coronary intervention (PCI) and one emergency medical service (EMS) group.

Two-thirds (67 percent) of the systems were in urban areas and most followed standard quality procedures and policies, including:

  • Admitting STEMI patients even when a hospital bed was not readily available (97 percent).
  • Requiring a single phone call to activate the catheterization lab for PCI treatment (92 percent).
  • Permitting the emergency department physician to activate the cath lab without consulting a cardiologist (87 percent) and allowing the cath lab to be activated without cardiology consult prior to the patient arriving at the (78 percent).
  • Participating in a data collection registry (84 percent).
The most common barrier to implementing systems was competition among hospitals (37 percent) and cardiology groups (21 percent). Twenty-six percent of the systems have difficulties with EMS transport and finances.

"It's essential to get competing hospitals and separate EMS agencies within a community to work as a team to provide optimal care for ," said James G. Jollis, M.D., the study's lead author and professor of medicine at Duke University Medical Center in Durham, N.C. "These study findings can serve as a benchmark and lessons learned as additional communities across the country create their own systems of coordinated, integrated, evidence-based care for STEMI patients."

PCI hospitals (84 percent) and/or cardiology practices (23 percent) provided funding for most of the systems.

More than 580 community-based STEMI systems are now registered in Mission: Lifeline, covering more than 60 percent of the U.S. population.

The American Heart Association's Mission: Lifeline Heart Attack Referring/Receiving Center Accreditation program now recognizes hospitals for quickly and appropriately treating heart attack patients. Ten hospitals have been accredited to date, with more applications being considered. About 200 hospitals also receive recognition awards each year for meeting certain performance criteria.

"Since Mission: Lifeline launched, we've seen major improvements in the coordinated care of patients," said Christopher Granger, M.D., study co-author, chair of the Mission: Lifeline STEMI advisory working group and professor of medicine at Duke University Medical Center in Durham, N.C. "Paramedics are making the STEMI diagnosis earlier, patients are being transported or transferred to appropriate hospitals more quickly, and blocked arteries are being opened faster ― all translating to more lives saved."

Using the survey as a snapshot, success can be improved upon even more to ensure that all patients are getting the recommended best practices in STEMI care, Granger said.

Explore further: Coordinated system helps heart attack patients get treatment faster

Related Stories

Coordinated system helps heart attack patients get treatment faster

June 28, 2011
Coordinating care among emergency medical services (EMS) and hospital systems significantly reduced the time to transfer heart attack patients to hospitals providing emergency coronary angioplasty, according to research reported ...

Heart attack patients taken to PCI hospitals first treated faster

May 10, 2012
Heart attack patients in North Carolina who were rushed directly to hospitals equipped to do percutaneous coronary intervention (PCI) received treatment significantly faster than patients first taken to hospitals unequipped ...

Emergency treatment for heart attack improving but delays still occur

September 19, 2011
Despite improvements in treating heart attack patients needing emergency artery-opening procedures, delays still occur, particularly in transferring patients to hospitals that can perform the procedure, according to a study ...

Most hospitals miss critical window for heart attack transfer patients

November 28, 2011
Most heart attack patients transferred between hospitals for the emergency artery-opening procedure called angioplasty are not transported as quickly as they should be, Yale School of medicine researchers report in the first ...

Is it time for regional cardiovascular emergency care systems across the US?

April 25, 2012
Experts are proposing a new model of care collaboration to diagnosis, treat and follow patients who present with various emergent cardiovascular conditions which require rapid, resource-intensive care and confer a high risk ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.