UK heart-attack survival rate 'should have been better'

Heart with heart attack trace superimposed Sweden's fast adoption of new technologies gave heart-attack victims more chance of survival, experts said

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Thousands of heart attack victims could have been saved if the UK had adopted similar treatment methods to Sweden, research suggests.

The study, outlined in the Lancet, looked at the quality of care and outcomes for heart patients in the UK and Sweden between 2004 and 2010.

Researchers believe more than 11,000 lives could have been saved if the UK had adopted similar technology sooner.

Heart experts say the UK is catching up but still needs to do more.

The researchers, from Sweden and the UK, compared data on the treatment of almost 120,000 patients in hospitals in Sweden and more than 390,000 in the UK over the seven years.

Sweden and the UK have similar health systems.

Both are universally available, funded by tax and free at the point of use - and have national guidance for the management of heart attacks.

They differ in size significantly: the population of the UK is more than 63 million, whereas Sweden's is between nine and 10 million.

Start Quote

The uptake and use of new technologies and effective treatments recommended in guidelines has been far quicker in Sweden”

End Quote Prof Harry Hemingway University College London

Results showed that 30 days after a heart attack, death rates for UK patients were more than a third higher than for Swedish patients - 10.5% for UK patients compared with 7.6% for Swedish.

The difference in death rates decreased over time, but mortality was always higher in the UK.

'Cause for concern'

The researchers took into account factors including age, sex, the severity of heart attacks, smoking, blood pressure and diabetes.

But even then, they estimated that 11,263 deaths over the seven years studied could have been "delayed or prevented" in the UK if patients had received the same care as their Swedish counterparts.

The main reason for the difference was found to be Sweden's pattern of introducing new technologies, such as developments in angioplasty treatments for blocked or narrowed arteries, faster.

In addition, Swedish doctors were more likely to prescribe the recommended treatments, such as beta blockers, when patients were discharged.

It also had "a more established system for evaluating and reporting the qualities and outcomes of care", the researchers said.

Prof Harry Hemingway, from University College London, who was one of those leading the work, said: "Our findings are a cause for concern. The uptake and use of new technologies and effective treatments recommended in guidelines has been far quicker in Sweden.

"This has contributed to large differences in the management and outcomes of patients".

He told the BBC the UK had made progress in the last few years.

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We need to be led by the research and introduce pioneering practices quickly and on a large scale”

End Quote Dr Mike Knapton British Heart Foundation

But he added: "It is plausible that the mortality gap persists. It is important to carry out these ongoing comparisons between countries.

'Complex reasons'

"The NHS has shown improvement compared to the past. What this study shows robustly is that isn't enough."

Dr Mike Knapton, associate medical director at the British Heart Foundation, said: "The reasons behind the differing survival rates are complex, but one explanation could be the speed with which the two countries adopted primary angioplasty (treatment for blocked arteries) as an emergency treatment.

"Sweden's early adoption meant they saw the benefits quicker and this is reflected in the figures.

"However, the UK has caught up and last year the majority of patients received this treatment.

He added: "The lesson here for the UK is that we need to be led by the research and introduce pioneering practices quickly and on a large scale."

Prof Adam Timmis and Iain Simpson, of the British Cardiovascular Society said the difference in size between the two countries potentially explained some of the difference in the speed with which technologies were introduced.

But they said the study was a "timely lesson" of the importance of "responding more promptly to emerging technologies and treatments, particularly those that can improve outcomes for patients with life-threatening disorders".

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