Study of Heart Drugs Includes Ojai Hospital

Ojai Valley Community Hospital has become one of 300 medical facilities nationwide to participate in an Oxford University-affiliated study to determine the effectiveness of clot-dissolving drugs for heart-attack patients.

The study, which will involve 40,000 heart-attack patients--each of whom will receive one of three available thrombolytic, or clot-dissolving, drugs--is expected to conclude sometime next year, hospital officials said.

A single dose of a clot-dissolving drug can cost as much as $2,200, but heart-attack patients at Ojai Valley Community Hospital--the only hospital in Ventura County participating in the study--pay nothing when they agree to receive one of the three drugs being studied.

Because it is a double-blind study, neither the patient nor the physician know which drug is being administered.

“We know all three of these drugs work, but no one has been able to determine if one of them is better than another at improving a person’s chances of survival” after a heart attack, said Dr. Jeffrey McManus, co-director of the intensive care unit at Ojai Valley Community Hospital.

“Until now, we haven’t known very much about which drugs work best or under what conditions,” he said.

Each Ventura County hospital treats an average of about 140 heart-attack patients each year, said Dr. Newton Friedman, a cardiologist with Ventura Cardiology Consultants and past president of the Ventura County Heart Assn. At least a third of those patients are given thrombolytic drugs, he said.

“If we could know for certain that one drug was the clear-cut advantage in increased survival, or when the optimum treatment time was, it would help us choose the best drug and probably save a lot of lives,” Friedman said.

Thrombolytic drugs first received Food and Drug Administration approval about six years ago, after they were found to be effective in reducing cardiac damage if used within the first few hours of the onset of a heart attack, McManus said.

One of the problems for physicians, however, is that many heart-attack victims wait for several hours after an attack begins before seeking medical treatment.

“A lot of people get heart attacks in the morning when the heart’s oxygen demands go up. They’ll have chest pains at 5 a.m. or 6 a.m., and then wait several hours to call because they don’t want to disturb their doctor, or maybe because they are in denial about it,” McManus said.

By that time, he added, a significant amount of damage already may have been done to the heart muscle. The risk of internal bleeding increases with at least one of the drugs, he said.

“Our first patient came in on Sunday. He was having a heart attack and got here within a half-hour of his first symptoms,” McManus said. “We don’t know which drug we gave him because it is a double-blind study, but within a short amount of time his electrocardiograph went almost back to normal.”