Cardiac Patient Heart Failure and Death Halved

A new study has found that the rate of heart failure and death among cardiac patients admitted to the hospital has nearly halved in the last six years because of the use of more effective drugs and treatments.

A large international study, led by researchers at the University of Edinburgh (UK) analyzed hospital data from 1999 to 2006 covering 44,372 patients who were admitted to 113 hospitals in 14 countries enrolled in the global registry of acute coronary events (GRACE). The patients were admitted with acute coronary symptoms (ACS) such as heart attack and unstable angina.

The results of the study showed that rates of new heart failure and death and incidence of stroke and heart attack after discharge fell over the first half of this decade. The study also found that the death rate for patients admitted with a severe heart attack--where the arteries are completely blocked--went down from 8.4% to 4.5%; the death rate for patients admitted with a milder heart attack--where the arteries are only partially blocked--also went down from 2.9% 2.0%; and the risk of heart failure for severe heart attack patients went down from 20% 11%. This equates to 30 fewer deaths and 90 fewer patients with new heart failure per 1,000 hospital admissions; critical heart failure or cardiogenic shock, which kills 70% of patients who suffer severe heart attacks, went down from 7.1% to 4.7 % among these patients.

The researchers also found that after hospital treatment, both severe and milder heart attack patients were less likely to have strokes or further heart attacks in the ensuing six months. For severe heart attack patients, the risk of stroke went down from 1.3% to 0.5% and the risk of a further heart attack than halved from 4.8% to 2.0%. For milder heart attack patients, the risk of stroke went down from 1.26% 0.67%, and the risk of a further heart attack went down from 3.0% 1.9%. The study was published in May 2, 2007, issue of the Journal of the American Medical Association (JAMA).

"We know that advances in medical treatments have improved outcomes due to large scale trials of therapies but there has been a substantial gap in knowing how this relates to how new drugs and procedures are being used and implemented in hospitals,” said lead author Keith A. Fox, a professor of cardiology at Edinburgh. "Our study enables us to look at differences in practice in a clinical setting over time and it has reflected significant changes in how patients with heart attacks are treated, showing that guidelines are being followed. As a result there is a major reduction in death rates.”


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