A 10-year study of 300,000 patients has found rapid rates in the uptake of stenting treatment that greatly improves chances of survival after they have suffered a major heart attack.
The UK research showed the use of emergency stenting – primary percutaneous coronary intervention – increased from 0.1% in 2003 to 86% in 2013 for patients with ST-elevation myocardial infarction, which accounts for 25-40% of all heart attack cases in Europe.
“Emergency stenting has revolutionised the way we now treat heart attack patients”
PPCI involves opening a blocked artery to restore blood flow to the oxygen-starved part of the heart and has helped save thousands of lives since becoming available in the early 2000s.
Previous studies have shown that recipients of the PPCI procedure are 37% less likely to die compared to those treated with clot busting drugs.
Introduction of PPCI followed a 10-year action plan for heart disease – the National Service Framework for Coronary Heart Disease – which led to an increase in the number of hospitals able to deliver the treatment.
Despite the rapid overall uptake, the study found vast differences in the provision of PPCI treatment between hospitals – prompting calls for better access.
The rise in provision of PPCI treatment between hospitals ranged from only a 4% increase in some places to a 300% increase elsewhere over the 10 years.
Patients with diabetes, angina or having previously had a heart attack were less likely to receive the treatment, due to chronic illness increasing the difficultly of diagnosis, according to the findings published in the journal Heart.
The research, led by the University of Leeds, was part funded by the British Heart Foundation and the National Institute of Health Research.
Study author Dr Chris Gale said: “Emergency stenting has revolutionised the way we now treat heart attack patients and our research highlighted just how far we have come over the past 10 years, with the vast majority of patients now receiving the best care.
“However it’s clear that opportunities are being missed and in some cases treatment is simply not being offered,” he said. “This is unacceptable and undoubtedly lives are being lost as a result.”
“We need to ensure that the NHS provides enough, sufficiently resourced heart attack centres providing round the clock PPCI”
The British Heart Foundation said all patients having a STEMI should be taken to a designated heart attack centre with the facilities and staff to deliver round-the-clock PPCI, seven days a week.
In addition, the charity said emergency services needed to improve their ability to identify heart attacks in patients who were chronically ill with multiple symptoms.
Its medical director Professor Peter Weissberg said: “It is a testament to the NHS and its investment through the National Service Framework for Coronary Heart Disease that today nine in 10 people who suffer a major heart attack in the UK are treated by PPCI.
“But clearly we need to do even better to guarantee all patients across the UK receive the best possible treatment,” he said.
“We need to ensure that the NHS provides enough, sufficiently resourced heart attack centres providing round the clock PPCI, to avoid needless loss of life,” he added.