News | December 16, 2014

Faster, Coordinated STEMI Response Could Help More Patients Survive Heart Attacks

Hospitals part of the American Heart Association’s national network working to improve heart attack patient care

Cath lab, clinical trial, clinical study, defibrillator monitors

December 16, 2014 — A faster, coordinated emergency response in collaboration with hospital cardiac catheterization laboratories in each United States region, including New York City, is associated with improving patient survival from a heart attack caused by a sudden, completely blocked artery called an ST-elevated myocardial infarction (STEMI), according to a study presented at the American Heart Association Scientific Sessions 2014.

Mount Sinai St. Luke’s, Mount Sinai Roosevelt, The Mount Sinai Hospital, Mount Sinai Beth Israel and Mount Sinai Queens were part of a 484-hospital, 16-region effort funded by the American Heart Association’s (AHA) Regional Systems of Care Demonstration Project: Mission: Lifeline STEMI ACCELERATOR. The project tracked the care of more than 24,000 heart attack patients between 2012 and 2014 after implementing universal treatment protocols, data collection system, measurement and feedback to rapidly diagnose and treat heart attack patients.

The collaboration is creating faster response for patients experiencing a STEMI heart attack. Quickly opening the blocked artery can restore normal blood flow and minimize heart damage, but nearly half of the more than 250,000 U.S. STEMI patients each year are not treated within the recommended 90 minutes.

One main goal of the study, and the larger AHA program, is to create systems that ensure STEMI heart attack patients are treated in a cardiac catheterization laboratory within 90 minutes of first medical contact. New results of the national study show that the number of patients treated within 90 minutes has increased from 54%to 59% since 2012. Also, some regions improved by more than 15 percent. Additionally, the study showed shorter emergency room wait times, or even bypassing the emergency room all together, was associated with improved patient survival, and a death rate of 3.6%.

Jacqueline Tamis-Holland, M.D., of Mount Sinai St. Luke’s and Mount Sinai Roosevelt, is a member of the Executive Committee for New York City’s Mission Lifeline STEMI ACCELERATOR program. NYC hospitals and the Fire Department of the City of New York (FDNY) worked closely with paramedic teams to reduce the time window from when the patient called 911 to the patient’s arrival in a catheterization laboratory that can open a blocked artery from STEMI.

“One of our greatest achievements was to create a protocol to send eligible patients with heart attacks directly from the ambulance to the catheterization laboratory without first stopping for their examination in the emergency room,” says Tamis-Holland. “This has been very successful as a result of direct communication between the FDNY, the hospitals and the new agreed upon protocol that certain patients should go immediately to the catheterization laboratory.”

In New York City, it usually takes 55 to 60 minutes for a STEMI heart attack patient who arrives to the emergency room to have their blocked artery opened in the catheterization laboratory. As a result of this AHA project, the time it takes for the opening of a blocked STEMI artery for patients going directly to the catheterization laboratory, bypassing the emergency room, has been accomplished in less than 30 minutes after their arrival to the hospital.

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