Study shows wide variation in emergency heart treatment

A 10 year study has found wide variation in emergency treatment for patients with blocked coronary arteries.

The study of 300,000 patients across 84 hospital trusts in England found that patients were twice as likely to receive life saving stents to open blocked arteries, a procedure known as primary percutaneous coronary intervention (PPCI), if they were taken to units which operate a 24/7 service.

Patients who suffer a major heart attack are supposed to be offered treatment within 90 minutes, but the study found that 43 per cent of trusts which offer the emergency procedure are still unable to do so 24 hours a day, seven days a week.

The study also found that patients were 30 per cent more likely to receive stents in hospitals that have more than five cardiologists trained in the procedure.

Despite the variation in care, the study did find that the number of trusts performing the emergency procedure 24/7 increased from 7.2 per cent in 2005-07 to 57 per cent in 2011-13.

The authors of the study, led by Leeds University, said: “Supply factors, such as numbers of cardiologists and availability of a 24-hour, seven-days-a-week PPCI service were strong determinants of PPCI utilisation.

“Our findings provide evidence to suggest that PPCI-capable hospitals must have an ‘all-comers’ policy that is compliant with clinical guidelines, provide a 24-hour, seven-days-a-week service, be adequately staffed with specialists, and not be so large that there are diseconomies of scale.”

Dr Chris Gale, from Leeds University, said: “Emergency stenting has revolutionised the way we now treat heart attack patients and our research highlighted just how far we have come over the past 10 years, with the vast majority of patients now receiving the best care.

“However, it’s clear that opportunities are being missed and in some cases treatment is simply not being offered. This is unacceptable and undoubtedly lives are being lost as a result.”

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