Heart attacks are less deadly when doctors follow guidelines

A heart attack is less deadly if doctors follow guidelines for treating them, a new report suggests. This may sound obvious, but getting people on board with new technology isn’t always easy, as an accompanying editorial points out. Such analyses stress the importance of keeping doctors up to speed.

Researchers from the Karolinska Institutet in Stockholm looked through a Swedish database to find more than 61,000 patients who between 1996 and 2007 had a type of severe heart attack in which a coronary artery suddenly becomes blocked, depriving a large portion of heart muscle of blood. The risk of death in such heart attacks is high, and patients need immediate care.

In that time period, new guidelines were gradually adopted throughout Sweden for how to treat patients who just had such heart attacks, known as ST segment elevation myocardial infarctions, or STEMIs.

Similarly, the use of drugs to unclog arteries and procedures to open narrowed arteries became more common.

Overall during that time period, the percentage of patients dying in hospitals fell from 12.5% to 7.2%. And fewer patients died 30 days or pme year after their heart attacks. Similarly, life expectancy increased —the researchers calculated that someone with a heart attack in 2007 would live an average of 2.7 years longer than those who had a heart attack in 1995.

The results were published Wednesday in the Journal of the American Medical Assn.

The authors can’t know for certain that the guidelines resulted in fewer people dying from heart attack. But they seemed fairly confident, writing:

“In conclusion, registry-supported implementation of new treatment strategies over 12 years in STEMI patients in Sweden were associated with an increased use of evidence-based treatments, better adherence to treatment guidelines, and reduced variation across hospitals. These gradual changes in practice were associated with a large and sustained reduction in mortality.”

In the same issue, Dr. Debabrata Mukherjee, a professor of internal medicine at Texas Tech University Health Sciences Center in El Paso, wrote:

“The results have significant clinical implications for clinicians, hospitals, and patients. They point to an opportunity to improve the quality of care provided to patients with STEMI by decreasing the lag time for adoption of life-saving therapies and improving adherence to evidence-based care across hospitals.”

Decreasing the lag time will be key. Mukheriee offers suggestions; the research adds the impetus.