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New EKG Add-On Could Reduce Deaths from Heart Attack

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Media Advisory: September 30, 1997

Busy emergency room doctors now have a new ally in their fight to save heart attack victims from dying. The ally is a computerized decision-making aid built into the standard electrocardiograph (EKG) machine that instantly prints predictions, based on the patient's EKG and other clinical information, of whether that individual is likely to benefit from potentially lifesaving treatment with thrombolytic (clot-dissolving) drugs.

The new real-time predictive instrument was developed and tested by a team of researchers under a grant from the federal government's Agency for Health Care Policy and Research (AHCPR). The description of the instrument and all necessary details to calculate its predictions for any patient with a heart attack are published in the October 1 issue of Annals of Internal Medicine.

"This marks an important step forward in the fight to cut deaths from heart attack," said AHCPR Administrator John M. Eisenberg, M.D. "It's also a prime example of how health services research aids everyday medical care." Dr. Eisenberg said physicians currently base thrombolytic therapy decisions mostly on the same kinds of information the instrument uses, but that the new tool can make the process more systematic, precise and practical.

Thrombolytic drugs help many patients survive a heart attack if administered in time. However, if the drugs are administered too late, or given to patients unlikely to benefit, they are of little or no help, may cause serious complications, and waste money.

Other than timing (AHCPR-funded and other research shows that heart attack victims often delay seeking care) the main reasons more patients do not receive thrombolytic care is failure to recognize suitable candidates and fear of complications.

According to the research team leader, Harry P. Selker, M.D., of Boston's New England Medical Center, the new instrument estimates the patient's probabilities (from zero to 100 percent) of suffering cardiac arrest within 48 hours, of dying within 30 days or of dying within one year, if the patient is, or is not, treated with thrombolytic therapy in the emergency room. The instrument also calculates the patient's likelihood of developing serious complications, such as hemorrhagic stroke or major bleeding, if given thrombolytic therapy.

The study involved researchers from Tufts University School of Medicine, Duke University Medical Center, University of Washington School of Medicine, Boston University Department of Mathematics, Harbor-UCLA Medical Center and the University of Southern California Department of Medicine.

Dr. Selker's study is one of a series of research projects supported by AHCPR to improve the quality and effectiveness of clinical care. AHCPR is currently funding a follow-up, randomized controlled trial in a diverse group of 28 hospitals across the country to test the clinical impact of making this thrombolytic predictive instrument available in emergency rooms.

To arrange an interview of Dr. Selker, please contact Melissa McPherson of New England Medical Center's External Affairs Office, (617) 636-3265.

For additional information, contact AHCPR Public Affairs: Salina Prasad, (301) 427-1864 (SPrasad@ahrq.gov).

The information on this page is archived and provided for reference purposes only.

 

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