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Hospital Primary Angioplasty Experience Is Associated with Survival for Heart Attack Patients

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Research Alert: May 24, 2000

Heart attack patients who are treated at hospitals experienced in performing large numbers of primary angioplasty procedures have higher survival rates, according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ). University of Alabama at Birmingham researchers found that patients treated at experienced hospitals had a 28 percent lower mortality rate for primary angioplasty (opening blocked arteries by inflating a balloon catheter) than patients treated at the less experienced hospitals. This equals two fewer deaths per100 patients treated. The study is in the May 25, 2000, issue of New England Journal of Medicine.

Researchers also studied heart attack patients who received thrombolytic drugs (medications that break up clots to restore blood flow in arteries). In contrast to the primary angioplasty findings, there was no statistical difference in the relationship between the hospital experience and patient survival rates.

The inverse relation between the volume of primary angioplasty procedures and in-hospital mortality may be because physicians improved their skills through practice. Also, high-volume hospitals have systems in place which help them apply the procedures to heart attack patients faster, perhaps causing an increase in survival rates. In contrast, resources and the expertise required for the proper administration of thrombolytic drugs are less technical compared with those required for the proper performance of primary angioplasty.

Researchers conclude that these findings may help centers with high or low-volumes develop protocols for life-saving therapies to minimize indecision in choosing between alternative treatments.

Note to Editors: The study article is entitled: "Relation between the Volume of Primary Angioplasty Procedures and Survival in Acute Myocardial Infarction," by John G. Canto, M.D., M. S. P. H.; Nathan R. Every, M.D., M.P.H.; David Magid, M.D., M.P.H.; William J. Rogers, M.D.; and others. For further details or interviews, call Dr. Canto at (205) 934-2936 or Dr. Magid at (303) 344-7541.

For additional information, contact AHRQ Public Affairs, (301) 427-1364.

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