News | November 21, 2014

AHA Study: Coordinated, Faster Emergency Response Associated with Improved Heart Attack Survival

Collaboration between paramedics and hospitals in treating heart attack patients resulted in shorter emergency department wait times, better survival

November 21, 2014 — A coordinated emergency response by healthcare teams to treat heart attack patients meant faster care that was associated with improved survival, according to research presented at the American Heart Association’s Scientific Sessions 2014.

The Regional Systems of Care Demonstration Project: Mission: Lifeline STEMI ACCELERATOR — one of the largest systems-of-care efforts to improve heart attack care — included 16 metropolitan areas comprising about 10 percent of the United States population. Researchers tracked more than 24,000 heart attack patients across 484 hospitals and 1,258 emergency medical services (EMS) agencies during the implementation phase of the project July 1, 2012-March 31, 2014.

Healthcare leadership teams across the regions established standard treatment protocols, a universal data collection system and ongoing measurement and feedback to rapidly diagnose and treat heart attack patients.

In the first 12 months of the project:

  • Patients arriving by EMS treated within 90 minutes of first medical contact increased from 54 percent to 59 percent (p = 0.0046).
  • Some regions improved more than 15 percent.

 

“The key to success was the collaboration between paramedics, hospital teams and interventional cardiologists working to provide care quickly,” said Christopher Granger, M.D., senior author of the study and director of the cardiac intensive care unit at Duke University Medical Center in Durham, N.C. “With in-the-field diagnosis and activation of hospital catheterization laboratories prior to hospital arrival, time spent waiting in the emergency department for the catheterization team to be available was minimized.”

Shorter emergency department (ED) times (adjusted for several covariates) were associated with improved survival (p< 0.001):

  • The death rate was 3.6 percent for patients in the ED 30 minutes or less.
  • The death rate increased to 7.0 percent for patients waiting in the ED 30-45 minutes.
  • Those waiting in the ED longer than 45 minutes had a 10.8 percent death rate. 

 

The project focused on ST segment elevation myocardial infarction (STEMI), the type of heart attack that occurs when a vessel supplying blood to the heart is suddenly and completely blocked. Quickly opening the blocked artery can restore normal blood flow and minimize heart damage.

Nearly half of the more than 250,000 people who have a STEMI each year in the United States aren’t treated within the recommended 90 minutes. The American Heart Association created Mission: Lifeline in 2007 to bring together hospitals, emergency medical services and communities to overcome delays in treatment. Mission: Lifeline STEMI now includes 827 community-based systems, covering 82.5 percent of the U.S. population.

The American Heart Association and regional and national leaders led the ACCELERATOR initiative, coordinated through Duke University, with the Duke Clinical Research Institute as the coordinating center.

 “These findings validate the concept that the collaborative systems-of-care model we launched with our Mission: Lifeline initiative seven years ago can speed heart attack treatment and save lives,” said Alice Jacobs, M.D., AHA past president, original chair of the AHA Mission: Lifeline Advisory Working Group and professor of medicine and Vice Chair for Clinical Affairs, Department of Medicine at Boston University Medical Center. “Lessons from the demonstration project can be used to guide our future efforts to further improve heart attack care in the U.S. and beyond.”

Co-authors are James G. Jollis, M.D.; Matthew W. Sherwood, M.D., M.H.S.; Hussein R. Al-Khalidi, Ph.D.; Mayme L. Roettig, R.N. M.S.N.; Claire C Corbett, M.M.S., N.R.EMT-P.; Harold L Dauerman, M.D.; Kathleen Fox, R.N., B.S.; J. Lee Garvey, M.D.; Timothy D Henry, M.D.; Ivan C Rokos, M.D.; B. Hadley Wilson, M.D.; Author disclosures are on the manuscript.

The Medicines Company, AstraZeneca, Philips Healthcare and Abiomed funded the study.

For more information: www.heart.org

Related Content

DISRUPT BTK Study Shows Positive Results With Lithoplasty in Calcified Lesions Below the Knee
News | Peripheral Artery Disease (PAD)| September 20, 2017
Shockwave Medical reported positive results from the DISRUPT BTK Study, which were presented at the annual...
Corindus Announces First Patient Enrolled in PRECISION GRX Registry
News | Robotic Systems| September 18, 2017
September 18, 2017 — Corindus Vascular Robotics Inc.
Two-Year ILLUMENATE Trial Data Demonstrate Efficacy of Stellarex Drug-Coated Balloon
News | Drug-Eluting Balloons| September 18, 2017
Philips announced the two-year results from the ILLUMENATE European randomized clinical trial (EU RCT) demonstrating...
Sentinel Cerebral Protection System Significantly Reduces Stroke and Mortality in TAVR
News | Embolic Protection Devices| September 18, 2017
September 18, 2017 – Claret Medical announced publication of a new study in the...
Fysicon Receives FDA Approval for QMAPP Hemodynamic Monitoring System
Technology | Hemodynamic Monitoring Systems| September 18, 2017
Fysicon announced that it has been granted 510(k) clearance by the U.S. Food and Drug Administration (FDA) for its...
Marijuana Associated With Three-Fold Risk of Death From Hypertension
News | Hypertension| September 14, 2017
Marijuana use is associated with a three-fold risk of death from hypertension, according to research published recently...
Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Feature | Cath Lab| September 14, 2017
September 14, 2017 — Here are quick summaries for all the key late-breaking vascular and endovascular clinical trials
Mississippi Surgical and Vascular Center Uses Toshiba Ultimax-i FPD to Save Patients' Limbs
News | Angiography| September 14, 2017
The southern U.S. sees some of the highest numbers of chronic medical conditions, such as peripheral artery disease...
Sponsored Content | Videos | Structural Heart Occluders| September 13, 2017
Ziyad Hijazi, M.D., MPH, MSCAI, FACC, director of the cardiac program and chair of the Department of Pediatrics at Si
Philips Showcases Integrated Vascular Solutions at VIVA 2017
News | Peripheral Artery Disease (PAD)| September 13, 2017
Philips announced its presence at the Vascular Interventional Advances (VIVA 17) Annual Conference in Las Vegas from...
Overlay Init