By William Weir The Hartford Courant
HARTFORD, Conn. — In an overwhelming number of cases it takes longer than it should to transfer heart attack patients between hospitals for emergency artery-opening angioplasty, Yale School of Medicine researchers reported in a study published this week.
If a heart attack patient is admitted to a hospital that doesn’t offer angioplasty, guidelines recommend that the patient be transferred within 30 minutes to a hospital that offers the procedure. According to the study, which appeared in Monday’s issue of the Archives of Internal Medicine, fewer than 10 percent of cases meet these guidelines. In about one-third of cases, It takes more than 90 minutes to transfer the patients.
The study looks specifically at patients who suffered ST-segment elevation myocardial infarction (STEMI). Because a blockage of blood to the heart causes this type of heart attack, fast response is of utmost importance.
“Some of these patients are taking two to three hours to get their treatment,” said Jeph Herrin, an assistant adjunct professor of cardiology at Yale School of Medicine who led the study. “Every additional minute of delay causes some small risk of mortality in these patients. There’s no such thing as too fast — 15 minutes would be even better. The sooner you get the blood going to the heart the better the recovery.”
In this country, the preponderance of hospitals offer angioplasty, Herrin said, but some — mostly small rural hospitals — do not because they don’t have the staff or facilities to do so. The study examined data from these hospitals.
The study makes use of 2009 data from the Centers for Medicare &Medicaid Services on all heart attack patients with STEMI. That year, almost 14,000 heart attack patients were transferred from hospitals that didn’t offer angioplasty to hospitals that did.
The study doesn’t look at what causes the delays.
“That’s probably the next stage of research,” Herrin said. “Our group would be interested in looking at that. I’m not a physician, so I’d work with others who understand what’s happening in the emergency department.”