Disparity in care for heart attack patients

August 31, 2017, University of Leeds
Disparity in care for heart attack patients
Credit: University of Leeds

Heart attack patients with long-term health conditions are significantly less likely to receive optimal care, compared to those with no long-term health problems – according to new research.

The disparity in care is associated with a higher risk of death, according to a study by researchers at the University of Leeds.

The study – part funded by the British Heart Foundation – involved an analysis of the records of almost 700,000 treated for a in 247 hospitals in England between 2003 and 2013.

The researchers looked at the various medical guidelines in place at the time as well as the treatments they recommended, and then assessed whether those treatments were given.

The team found that 40 per cent of patients with heart attack also had a long-term health condition, such as diabetes, stroke, and .

Significant increased risk of death

Of those, 86 per cent did not receive optimal or the most desirable care, and these patients had a 250 per cent increased risk of dying, compared with patients who did not have a long-term condition.

The researchers also found that patients with heart attack and heart failure or renal failure were the least likely to receive optimal care.

Patients with heart failure received 7.3% fewer treatments than with no long-term , whilst patients with renal failure received 6.1% fewer treatments.

These patients had the highest risk of death, and for patients with heart failure and a heart attack, the researchers found that despite optimal heart attack care the risk of death was similar to patients who did not receive all heart attack care opportunities.

Chris Gale, Professor of Cardiovascular Medicine at the Leeds Institute of Cardiovascular and Metabolic Medicine, led the research.

He said: "This 10-year national study of nearly 700,000 patients with heart attack shows for the first time how a wide range of long-term health conditions impacts on survivorship following acute myocardial infarction or heart attack.

Need for new therapies

"Having a long-term health condition, such as heart failure, renal failure or diabetes in addition to a heart attack was significantly associated with a worse clinical outcome.

"Whilst this was, in part, mediated by missed-opportunities in the delivery of care, evidence from this study suggests that there is a need for new therapeutic interventions to improve survival for patients with heart attack who also have long-term health conditions."

However, the study does have limitations in that it relies on the accuracy of patient data recorded in the Myocardial Ischaemia National Audit Project or MINAP database.

Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said: "It's important that all patients receive the best possible treatments, regardless of any other conditions they might have. But it's true that having another long-term condition can complicate things.

"Choosing the best has to factor in the other medicines that the patient is taking, as well as the potential side-effects. This sometimes means a person doesn't necessarily get the most effective treatments, but it still could be the best choice under the circumstances.

"This study shows that patients with long-term conditions could see substantial benefits if extra effort is put into deciding the best possible treatments. It also highlights the need for research to develop further treatment options for doctors and more effective medicines for these patients."

The British Heart Foundation says someone suffers a heart attack approximately every three minutes in the UK, with nearly 200 people of working age dying every week of a attack in the UK.

The findings were presented at the European Society of Cardiology congress.

Explore further: Some heart attack patients may not benefit from beta blockers

Related Stories

Some heart attack patients may not benefit from beta blockers

May 29, 2017
New research challenges established medical practice that all heart attack patients should be on beta blockers.

Diabetes may have important effects in patients with acute heart failure

June 26, 2017
Researchers have found that patients with acute heart failure and diabetes, compared with those without diabetes, have distinct markers related to inflammation, cardiovascular function, and kidney health.

Failures in heart attack care?

May 10, 2016
A new study has found that thousands of deaths could have been avoided if heart attack aftercare guidelines outlining when to give treatment were followed.

One in four patients develop heart failure within four years of first heart attack

May 24, 2016
One in four patients develop heart failure within four years of a first heart attack, according to a study in nearly 25 000 patients presented today at Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure ...

Heart failure and stroke identified as lethal combination

May 20, 2017
Heart failure and stroke has been identified as a lethal combination in research presented today at EuroHeartCare 2017. Heart failure patients with previous stroke had greater risks of depression, hospitalisation and death ...

Bleeding hearts predict future heart failure

June 9, 2016
The amount a heart 'bleeds' following a heart attack can predict the severity of future heart failure, according to research presented today by a University of Glasgow academic at the British Cardiovascular Conference, in ...

Recommended for you

No sweat required: Team finds hypertension treatment that mimics effect of exercise

October 16, 2018
Couch potatoes rejoice—there might be a way to get the blood pressure lowering benefits of exercise in pill form.

New model suggests cuffless, non-invasive blood pressure monitoring possible using pulse waves

October 16, 2018
A large team of researchers from several institutions in China and the U.S. has developed a model that suggests it should be possible to create a cuffless, non-invasive blood pressure monitor based on measuring pulse waves. ...

Why heart contractions are weaker in those with hypertrophic cardiomyopathy

October 16, 2018
When a young athlete suddenly dies of a heart attack, chances are high that they suffer from familial hypertrophic cardiomyopathy (HCM). Itis the most common genetic heart disease in the US and affects an estimated 1 in 500 ...

Novel genetic study sheds new light on risk of heart attack

October 12, 2018
Loss of a protein that regulates mitochondrial function can greatly increase the risk of myocardial infarction (heart attack), Vanderbilt scientists reported Oct. 3 in the journal eLife.

Researchers say ritual for orthodox Jewish men may offer heart benefits

October 11, 2018
A pilot study led by researchers at the University of Cincinnati (UC) College of Medicine suggests Jewish men who practice wearing tefillin, which involves the tight wrapping of an arm with leather banding as part of daily ...

Markers of dairy fat consumption linked to lower risk of type two diabetes

October 10, 2018
Higher levels of biomarkers of dairy fat consumption are associated with a lower risk of developing type 2 diabetes, according to new research published today in PLOS Medicine. The study, in more than 60,000 adults, was undertaken ...

0 comments

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.