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Last Updated: Friday, 10 December, 2004, 00:08 GMT
24 hour heart service saves lives
Angioplasty at Hammersmith Hospital
The Hammersmith team in action
A service where heart attack patients are sent for treatment within the hour has reduced death-rates five-fold, doctors say.

Hammersmith Hospitals in London operates the 24-hour service unblocking the arteries of heart-attack patients.

It says the angioplasty service, set up with the London Ambulance Service, is the first of its kind in the UK.

The British Heart Foundation said the service should be seen as "another string to a cardiologist's bow".

Around 270,000 people have a heart attack each year in the UK, leading to 150,000 deaths.

Clot-busters

When the London Ambulance Service in the Hammersmith area is called out to a patient experiencing a heart attack, the primary angioplasty team is alerted, whatever the time of day or night.

Conventional therapy is effective - these results simply show that primary angioplasty has the potential to add another significant string to the cardiologist's bow
Professor Peter Weissberg, British Heart Foundation
The patient is then taken straight to Hammersmith Hospital to be treated by team, even if another hospital is nearer.

The average time from a patient arriving at hospital to reperfusion - the point at which blood flow returns to the heart muscle - is 84 minutes.

The standard treatment is for patients to be given clot-busting drugs to dissolve the blood clots causing the obstruction. They need to be given quickly to be effective.

While over 81% of patients across England receive these drugs within 30 minutes of arriving in hospital, the Hammersmith researchers say they are only effective in 50% to 60% of cases, compared to a 95% success rate for the angioplasty scheme.

In an angioplasty, a catheter is passed through an artery, usually in the groin, to the heart where a balloon is inflated in the blockage to reopen the blood vessel.

A support, called a stent is left in place to strengthen the artery wall.

In the first year of Hammersmith's primary angioplasty scheme 162 patients were treated.

There were four deaths, a rate of less than 2.5%. With the clot-busting drug treatment, the mortality rate is over 15%.

The service has also been found to halve the length of hospital stays from an average of eight days to four.

Three hospitals, West Middlesex Hospital, Charing Cross, and Hammersmith, are currently covered by the scheme. Ealing Hospital is also planning to join the service.

It has been estimated that the initiative will save 30,000 bed days a year in west London, and also lead to savings in drug, equipment and staff costs.

'A vanguard service'

Dr Kevin Beatt, the consultant cardiologist leading the scheme, said: "We have had to get a group together who have agreed to do this - not just doctors, but nurses and technicians too.

He added: "We have clearly achieved what we set out to do."

Dr Beatt said the scheme had also had knock-on benefits for non-emergency patients, as more of them were being given angioplasties, rather than having operations as the team became more practised at carrying out the procedure on sicker patients.

Professor Peter Weissberg, Medical Director designate of the British Heart Foundation, said: "The advantages of angioplasty over thrombolysis (clot-busting therapy) are well established and it is encouraging to see Hammersmith's new 24-hour angioplasty service is achieving good results.

"Such practice is a vanguard service which is setting a standard for others to follow."

But he added: "Not all patients are suitable for angioplasty and we would be concerned if these impressive-sounding results were interpreted as meaning that current conventional therapy is not up to standard.

"Conventional therapy is effective - these results simply show that primary angioplasty has the potential to add another significant string to the cardiologist's bow."

Roger Boyle, the government's national director for heart disease, said: "The way we're tackling this is to set up 10 pilots across country to learn big stumbling blocks and then spread over time to rest of country.

"We've seen pilots showing that it can work."


SEE ALSO:
Heart death 'may be eradicated'
24 Mar 04 |  Health
Heart policy 'saving thousands'
03 Mar 03 |  Health


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