News | August 08, 2007

10 Percent of Patients Miss Out on Angioplasty

August 9, 2007 - Compared with their counterparts a decade ago, today's heart attack patients are receiving emergency angioplasty or clot-busting drugs to re-open clogged arteries at a far greater rate, but 10 percent of patients who could benefit from this life-saving treatment still do not receive it, according to a study published in The American Journal of Medicine by Yale and University of Michigan researchers.

The results also showed that the chance of missing out on lifesaving emergency treatment was highest among patients without typical symptoms like chest pain, patients who did not arrive at the hospital until six or more hours after the heart attack began, female patients, those over age 75 and non-whites.

The 10-year study was based on data from 238,291 heart attack patients between 1994 and 2003 who were listed in the National Registry of Myocardial Infarction. The patients had a particular kind of heart attack called ST-elevated myocardial infarction (STEMI). It is the most current and comprehensive look at the use of emergency reperfusion, a treatment that can restore blood flow to the heart muscle. To track the changes in emergency reperfusion therapy over time, the researchers divided the study data into three time periods: June 1994 through May 1997, June 1997 through May 2000, and June 2000 through May 2003.

"This study has good and bad news," said senior author Harlan M. Krumholz, M.D., the Harold H. Hines, Jr. Professor of Medicine at Yale School of Medicine. "We have definitely made progress in treating appropriate patients, but our findings indicate that we need to improve further to be sure that no patient who could benefit from treatment is missed."

"We may never be able to get to 100 percent, but 10 percent of eligible patients going untreated is still too many," said first author Brahmajee Nallamothu, M.D., assistant professor of cardiovascular medicine at the University of Michigan Medical School. "We hope our study highlights the opportunities to improve care and particularly some of the "at risk" subgroups still less likely to receive reperfusion therapy despite eligibility, so that we can focus our clinical efforts on them."

Hospitals around the nation, including Yale-New Haven and University of Michigan, are taking part in a national campaign to reduce "door-to-balloon" times-the time from when a STEMI patient enters hospital doors to the time blood flow is restored to the heart by opening a blockage with angioplasty.

The National Heart, Lung and Blood Institute of the National Institutes of Health funded the study. Genentech, Inc. provided researchers with access to the registry.

Other authors on the study included Martha E. Blaney, Susan M. Morris, Lori Parsons, Dave P. Miller, John G. Canto, M.D., and Hal V. Barron, M.D.,

Citation: The American Journal of Medicine, Vol. 120, No. 8, (August 2007)

For more information: www.yale.edu

Related Content

The U.S. Food and Drug Administration (FDA) recently granted an additional indication to Bard Peripheral Vascular's Covera Vascular Covered Stent for the treatment of a stenosis or blockage which has developed anywhere in the access circuit of patients on hemodialysis using an arteriovenous (AV) fistula.
Technology | Stents | April 03, 2019
April 3, 2019 — The U.S.

A comparison of stent strut thickness between the Orsiro stent, pictured, and the market-leading stents on the U.S. and European markets. Vendors have been working toward reducing strut thickness to help improve overall clinical outcomes. Orsiro is now the smallest strut stent available on the market. 

Feature | Stents | February 22, 2019 | Dave Fornell, Editor
February 22, 2019 — The U.S.
The Medtronic Resolute Integrity drug-eluting stent is among the top three stents on the U.S. market. Outcomes for these stents are very similar, so the stents have largely become a commodity product purchased on price rather than clinical data. Stent advances and new stent technologies.

The Medtronic Resolute Integrity drug-eluting stent (DES) is among the top three stents on the U.S. market. Outcomes for these stents are very similar, so the stents have largely become a commodity product purchased on price rather than clinical data.

Feature | Stents | January 29, 2019 | Dave Fornell, Editor
There was a lot of hype and high hopes pinned on bioresorbable stent technologies as the way of the future two years
The Indian-made SMT SuperFlex stent. SMT has been developing stents and other interventional products designed to be a more affordable, home-grown option for the growing Indian market.

The Indian-made SMT SuperFlex stent. SMT has been developing stents and other interventional products designed to be a more affordable, home-grown option for the growing Indian market.

News | Stents | January 22, 2019
The rise cardiovascular disease has been instrumental in fueling the coronary stent market share in the past few year
The Biotronik Osiro is an ultra thin strut, sirolimus-eluting stent. #TCT2018

The Biotronik Osiro is an ultra thin strut, sirolimus-eluting stent.

News | Stents | October 04, 2018
October 4, 2018 – Investigators unveiled clinical data from the independent BIONYX and SORT OUT IX all-comers trials
FDA Approves Biotronik's PK Papyrus Stent for Coronary Perforations
Technology | Stents | September 27, 2018
September 27, 2018 — Biotronik recently announced U.S.
Videos | Stents | September 11, 2018
This is an animation showing how the dedicated bifurcation stent developed by Advanced Bifurcation Systems (ABS) is d
Elixir Medical Corporation Unveils Transformational DynamX Stent Featuring Adaptive Segments that Uncage the Stented Artery
News | Stents | January 25, 2018
January 25, 2018 – Elixir Medical Corporation, a leader in the development of breakthrough adaptive remodeling techno
The TIDES-ACS results show us that the Optimax stent is noninferior in patients with acute coronary syndrome compared to Synergy.

The presentation of the ESC late-breaker TIDES-ACS results show us that the Optimax stent is noninferior in patients with acute coronary syndrome compared to Synergy.

News | Stents | November 24, 2017
November 24, 2017 – During a late-breaking session at the European Society of Cardiology (ESC) 2017 meeting, presente
News | Stents | November 10, 2017
Cordis, a Cardinal Health company, recently unveiled a comprehensive interventional cardiology portfolio, which now...
Overlay Init