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New Heart Procedure Greatly Reduces Chances of Future Heart Attack

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Heart Attacks Leading Cause of Death

According to the Centers for Disease Control, heart attacks are a leading cause of death for men and women in the U.S.  Each year, 1.2 million Americans suffer a heart attack and many of them die.  A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely restricted or stopped, typically because the coronary arteries that supply the heart with blood can become thicker and harder from a buildup of fat, cholesterol and other substances that comprise what is known as “plaque”.  This process is called atherosclerosis, and if a plaque breaks open and a blood clot forms that blocks blood flow, a heart attack occurs.

New Procedure Offers Hope for Minimizing Complications and Death from Heart Attacks

Although ways to prevent complications and death already existed for heart attack sufferers (e.g. getting to the hospital quickly by identifying the signs of a heart attack), some patients still experience problems.  However, a new study shows that a new heart procedure could greatly increase the chance of survival for heart attack patients.  The study, presented on Sunday at the European Society of Cardiology Congress 2013 in Amsterdam, included 465 patients that underwent emergency percutaneous coronary interventions.  During a PCI, doctors insert a tube into the patient’s blocked artery to keep it open and allow blood flow to the heart.  The study trial investigated whether investigating the body for other blocked arteries during a PCI improved patient outcomes.  The trial was so successful, that it was stopped earlier than its original end date.

Results Show Promise for New Heart Procedure Effectiveness

The study authors found that over 2 years of the trial, 21 patients in the preventative PCI group (e.g. a PCI for the main artery causing the blockage was treated with additional investigation and treatment of other blocked arteries) died, had another heart attack or developed refractory angina, compared to a whopping 53 patient in the PCI culprit-only group (e.g. treatment of the main artery that caused the heart attack only).  The study authors note that the additional investigation and treatment of other blocked arteries during a PCI takes about 20 extra minutes of procedure time, but that the initial upfront costs greatly reduce future costs associated with hospital admissions, cardiac investigations or procedures brought on by future heart attacks.

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    This isn’t new. This is the same procedure (PCI) applied to other blockages seen in the coronary (heart) vasculature at the time of the acute heart attack. This data, while interesting, is directly counter to existing data showing that working on non-infarct related arteries during the acute episode actually increases mortality and morbidity. The combined data actually create an operational dilemma: the current data re-affirm older data that complete revascularization results in better long-term outcomes, while focusing only on the infarct artery during an acute episode results in better short-term mortality and morbidity. There are still many questions regarding this trial that have yet to be answered.