Heart attack technique 'could save lives'

Heart angiogram
Image caption Every year 25,000 people in the UK have the kind of heart attack which is treated with an angioplasty

A new, relatively simple way of treating heart attacks could save thousands of lives, according to specialists at a Clydebank hospital.

It involves clearing all narrowed arteries when someone is admitted with a heart attack, rather than just the one which is completely blocked.

A trial, involving the Golden Jubilee National Hospital, was so successful that the research was stopped early.

Jubilee heart specialist Prof Colin Berry said the results were "striking".

Fatty deposits

Another cardiologist, Prof Keith Oldroyd, said: "At the moment when patients come in with a heart attack they have an emergency angiogram and we usually only treat the artery that has caused the heart attack.

"Many of these patients have additional narrowings in other arteries. We're treating all the narrowed arteries at the same time to see if that confers additional benefit."

Every year 25,000 people in the UK have the kind of heart attack which is treated with an angioplasty.

This involves inserting a stent, or thin tube, to open an artery and restore the blood flow.

Arteries become narrowed by fatty deposits, so although a blood clot may have only blocked one artery, other narrowed arteries are common.

Current UK recommendations advise specialists only to treat the artery which is completely blocked.

"Most cardiologists thought it wasn't safe to treat a second or third artery at the same time as the first artery," Prof Oldroyd said.

"Sometimes the patients would be brought back several weeks later or sometimes only medication would be used. The results of this trial suggest that this recommendation should be revisited."

Reducing costs

The trial involved 465 patients in five specialist heart centres around the UK. In addition to the Golden Jubilee, they were the London Chest Hospital, Morriston Hospital in Swansea, Freeman Hospital in Newcastle, and Norfolk and Norwich University Hospital.

Half of the trial participants had all their arteries cleared, the rest were treated in the conventional way.

Image caption Prof Keith Oldroyd said most patients had narrowings in more than one artery

The researchers found that the new technique reduced the combined risk of dying, having another heart attack or being left with angina by two-thirds - such a significant finding that the trial was stopped early.

It also only added an average of 20 minutes to each treatment.

The results have been published in the New England Journal of Medicine and were presented at an international conference in Amsterdam earlier this month.

Prof Colin Berry, heart specialist at the Golden Jubilee and the University of Glasgow, said: "They were some of the most striking results for a treatment that I have ever seen. The results of this trial really challenge clinical practice."

Heart specialists are now keen that even larger studies get under way as quickly as possible.

In the past, it has taken a decade or more for the latest evidence to be adopted into frontline medical care.

Prof Berry added: "It's appealing because it's a form of usual care that can be readily adopted across the UK.

"On the other hand there are logistical considerations and cost considerations. However, we would argue that reducing the likelihood of further cardiac events, potentially reducing the heart failure admissions to hospital, is going to reduce costs overall and this should be implemented as soon as possible."

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