 |
|
New approach to treating heart attacks reduces risk of life-threatening complications
June 25, 2009Transferring heart attack patients to specialized hospitals to undergo angioplasty within six hours after receiving clot-busting drugs reduces the risk of life-threatening complications including repeat heart attacks, according to a new study from St. Michael's Hospital and Southlake Regional Hospital.
The findings, published today in the New England Journal of Medicine, suggest that routine early transfer of patients after clot-busting drugs are administered results in significantly better outcomes than the current traditional practice of transferring patients only when the clot-busting drugs fail.
The study -which is the largest randomized trial of its kind to date -- followed 1,059 heart attack patients who were treated with clot-busting drugs at community hospital emergency departments in Ontario, Manitoba and Quebec. Researchers compared a strategy of transferring heart attack patients to hospitals with on-site angioplasty facilities to undergo angioplasty within six hours after administration of clot-busting drugs, as opposed to the traditional approach of transferring only those patients when clot-busting drug treatments are unsuccessful.
"When treating patients with heart attacks, timing is everything, " said Dr. Shaun Goodman, the study's chairman and associate head of cardiology at St. Michael's Hospital, "A patient's chances of recovery are significantly improved if care is provided in a setting where angioplasty can be done soon after clot-busting therapy is given."
All patients in the study initially sought treatment at a hospital without angioplasty capability and were treated with a newer clot-busting drug (tenecteplase). Patients were then randomly assigned to one of two groups: urgent transfer for angioplasty within six hours, or standard care (no transfer for angioplasty within the first 24 hours unless the clot-busting medication failed to restore blood flow in the blocked artery). Patients who received standard care often underwent angioplasty 24-72 hours after the heart attack.
Overall the research showed:
* 17 per cent of patients receiving standard care had serious cardiac complications within 30 days, compared with 11 per cent of those transferred immediately for angioplasty. That represents a 36 per cent reduction in potentially life-threatening complications, including repeat heart attacks, with no difference in major bleeding complications between the two groups.
* Patients who received the earlier angioplasty had lower rates of experiening chest pain (0.2 per cent as compared to 2.1 percent)
* These same patients had fewer episodes of second heart attacks (3.4 per cent v 5.7 per cent)
Angioplasty - which uses a combination of catheter-mounted balloons and stents to open a completely blocked coronary artery and restore blood flow to the heart - is accepted as the best initial treatment for heart attacks when performed within 90 minutes of arrival at a hospital.
"The challenge, though, is that this is a goal that few hospitals in the world can achieve unless they have angioplasty facilities on site," explained the study's primary author Dr. Warren Cantor of Southlake Regional Health Centre, adding that less than 25 per cent of hospitals in North America have these resources. Until now, physicians have been reluctant to transfer patients to another hospital to undergo angioplasty soon after administering clot-busting medication as a result of earlier studies that revealed excess bleeding and no benefit with this approach.
St. Michael's Hospital
"When treating patients with heart attacks, timing is everything, " said Dr. Shaun Goodman, the study's chairman and associate head of cardiology at St. Michael's Hospital, "A patient's chances of recovery are significantly improved if care is provided in a setting where angioplasty can be done soon after clot-busting therapy is given."
All patients in the study initially sought treatment at a hospital without angioplasty capability and were treated with a newer clot-busting drug (tenecteplase). Patients were then randomly assigned to one of two groups: urgent transfer for angioplasty within six hours, or standard care (no transfer for angioplasty within the first 24 hours unless the clot-busting medication failed to restore blood flow in the blocked artery). Patients who received standard care often underwent angioplasty 24-72 hours after the heart attack.
Overall the research showed:
* 17 per cent of patients receiving standard care had serious cardiac complications within 30 days, compared with 11 per cent of those transferred immediately for angioplasty. That represents a 36 per cent reduction in potentially life-threatening complications, including repeat heart attacks, with no difference in major bleeding complications between the two groups.
* Patients who received the earlier angioplasty had lower rates of experiening chest pain (0.2 per cent as compared to 2.1 percent)
* These same patients had fewer episodes of second heart attacks (3.4 per cent v 5.7 per cent)
Angioplasty - which uses a combination of catheter-mounted balloons and stents to open a completely blocked coronary artery and restore blood flow to the heart - is accepted as the best initial treatment for heart attacks when performed within 90 minutes of arrival at a hospital.
"The challenge, though, is that this is a goal that few hospitals in the world can achieve unless they have angioplasty facilities on site," explained the study's primary author Dr. Warren Cantor of Southlake Regional Health Centre, adding that less than 25 per cent of hospitals in North America have these resources. Until now, physicians have been reluctant to transfer patients to another hospital to undergo angioplasty soon after administering clot-busting medication as a result of earlier studies that revealed excess bleeding and no benefit with this approach.
St. Michael's Hospital
Angioplasty Current Events and Angioplasty News RSSYour Own Stem Cells Can Treat Heart Disease
The largest national stem cell study for heart disease showed the first evidence that transplanting a potent form of adult stem cells into the heart muscle of subjects with severe angina results in less pain and an improved ability to walk. The transplant subjects also experienced fewer deaths than those who didn't receive stem cells.
Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
The heart attack myth: Study establishes that women do have same the heart attack symptoms as men
The gender difference between men and women is a lot smaller than we've been led to believe when it comes to heart attack symptoms.
Lifestyle changes remain important in fighting peripheral arterial disease
Modifying the risk of peripheral arterial disease (or PAD)-with healthy lifestyle changes-remains vital to one's health, note researchers in a recent issue of the Journal of Vascular and Interventional Radiology.
Study questions need for routine intervention in patients with renovascular disease
Some invasive procedures that are becoming increasingly common as a first line of treatment for patients diagnosed with narrowed arteries in and around the kidneys may not be necessary.
Designing drugs and their antidotes together improves patient care
Imagine a surgical patient on a blood-thinning drug who starts bleeding more than expected, and an antidote that works immediately - because the blood thinner and antidote were designed to work together.
Pre-hospital organization: The first links in the chain of survival for heart attack patients
Mortality rate following a heart attack has fallen by more than 50% in Europe over the past 25 years. However, because only minor advances in the medical treatment of AMI are expected over the next decade, it is through organisational changes in the pre-hospital phase that mortality rate will continue this decline to below 5%.
Stent for life initiative
Primary angioplasty (with stent implantation) is the most effective therapy for acute myocardial infarction (AMI), but it is not available to many patients, even though most European countries have sufficient resources (ie, catheterisation laboratories) for its wider use.
Otamixaban for the treatment of patients with non-ST-elevation acute coronary syndromes
Data from a phase II trial of an investigational intravenous drug designed to block the formation of blood clots shows potential to reduce the risk of death, a second heart attack, or other coronary complications compared with the current standard of care in patients presenting with acute coronary syndromes (heart attacks or unstable angina).
New strategies for reperfusion therapy
A new trial has begun in order to ascertain once and for all whether the best strategy for patients who cannot receive P-PCI is early fibrinolysis, together with mandated angiography.
More Angioplasty Current Events and Angioplasty News Articles
 |
Classic Papers in Coronary Angioplasty by Clive Handler (Editor), Michael Cleman (Editor) Every medical specialty has a core of classic papers that reflect both the historical development of the discipline and point the way to present and future developments. A distinguished team of international contributors have been assembled by the Editors to identify, analyze and collate the most important articles from a broad range of publications that have become recognized as the defining articles in coronary angioplasty. It is a unique reference, for not only does it provide a single source for reviewing the most important papers in the discipline, it also provides a critical analysis of the strengths, weaknesses and the impact each paper has had on the development of coronary angioplasty. This book will be essential reading for cardiologists - in particular interventional... |
|
Carotid Endarterectomy & Angioplasty with Vein Patch--VHS John B. Chang, M.D., FACS. 26 mins. Long Island Vascular Clinic, Roslyn, NY. ADM Video Productions, Inc. | |
 |
Kardovite Capsules (180 Caps) by The Wolfe Clinic The Wolfe Clinics Kardovite Drops Kardovite has been scientifically formulated with traditional herbal ingredients used for centuries as a path to a healthier lifestyle. Kardovite Drops should be seen as a Herbal Preparation, designed to enhance health. Traditional use of these herbs indicate that they may improve blood circulation, help lower cholesterol, treat circulatory ailments, and help break up blood clots. THE SEVEN HERBS OF KARDOVITE ARE: Cayenne, Garlic, Hawthorn, Valerian, Milk Thistle, Ginkgo Biloba, and Bilberry. CAYENNE: Stimulates the appetite, increases the flow of saliva and other digestive juices, Increases the rate and efficiency of nutrient absorption, Reduces cholesterol levels and decreases the bloods tendency to form clots, Acts as a Hypotensive and a cardiac... |
 |
Concerns About Having a Second Heart Attack or Stroke Dr. Arnold P. Nerenberg (Composer) Dr. Nerenberg had a heart attack seven years ago and had an angioplasty procedure to a coronary artery. After seven years a second stent was needed for a second coronary artery which was 80% blocked; fortunately there was no heart attack. His symptoms included: confusion, weakness, angina, numbness of face, shortness of breath. His systolic blood pressure went to 222; he called the paramedics. Dr. Nerenberg gives practical advice on how to deal with such medical crisis from a medical, emotional, and spiritual approach. |
 |
Handbook of Angioplasty and Stenting Procedures (Techniques in Interventional Radiology) by Robert A. Morgan (Editor), Eric Walser (Editor) The objective of this series of handbooks in Interventional Radiology is to provide easily accessible technique specific information on interventional radiology procedures. This series would ensure all of the key elements are in place, to fulfill the need for topic-orientated books that could be left in the IR room or carry around. Watkinson and Lee will be the Series Editors. Each book will have an EU and a US editor recruited, who would in turn select contributors to their table of contents. The books within the series will follow a template highlighting key areas with bullet points, key-point summaries, with illustrations / line drawings etc, so that residents and fellows find them didactic and easy-to-read – a must-have. The template of each book will be... |
 |
Concerns About Having a Second Heart Attack or Stroke Also With: Dr. Arnold P. Nerenberg (Narrator), Dr. Arnold P. Nerenberg (Commentary) Dr. Nerenberg had a heart attack seven years ago and had an angioplasty procedure to a coronary artery. After seven years a second stent was needed for a second coronary artery which was 80% blocked; fortunately there was no heart attack. His symptoms included: confusion, weakness, angina, numbness of face, shortness of breath. His systolic blood pressure went to 222; he called the paramedics. Dr. Nerenberg gives practical advice on how to deal with such medical crisis from a medical, emotional, and spiritual approach. |
 |
Primary Angioplasty in Acute Myocardial Infarction (Contemporary Cardiology) by James E. Tcheng (Editor) The emergency treatment of acute myocardial infarction (AMI)-one of the leading causes of death throughout the world - with immediate cardiac cathterization and percutaneous coronary intervention, or primary angioplasty, is now considered the optimal approach to this deadly disorder. In "Primary Angioplasty in Acute Myocardial Infarction, Second Edition", leading investigators and experienced clinicians collect and summarize the world's literature and augment this with practical wisdom concerning this critically important form of care. Technical, professional, and administrative aspects are reviewed in clear detail. Among the topics covered are the technique and technology of direct angioplasty, patient selection, regulatory issues, performance metrics, clinical trials and outcomes,... |
 |
Primary Angioplasty: Mechanical Interventions for Acute Myocardial Infarction, Second Edition by David Antoniucci (Editor) Careggi Hospital, Florence, Italy. Provides an authoritative and comprehensive update on the rationale, techniques, and effectiveness of percutaneous mechanical revascularization for acute myocardial infarction. Features abundant halftone illustrations. |
 |
Clear Heart by Triuntity Did you know that EDTA is FDA approved. In medical studies, EDTA has been shown to be three times safer. In fact, EDTA is so safe for humans, the American Heart Association recommends massive direct intravenous injections as treatment for people who have been exposed to toxic levels of lead, mercury, aluminum, and cadmium. In fact, scientific studies have proven that EDTA is up to 82% effective at eliminating rogue calcium from plaque, causing clogs to soften, let go and be flushed away! |
 |
Vascular Interventional Radiology: Angioplasty, Stenting, Thrombolysis and Thrombectomy (Medical Radiology / Diagnostic Imaging) by Mark G. Cowling (Editor), L. Baert (Editor) This volume focuses on the current evidence surrounding the use of endovascular therapy. It updates and complements the earlier "Medical Radiology" volume on the Radiology of Peripheral Vascular Diseases. Some background information is provided on vascular biology and the facilities required for safe endovascular practice, along with guidance on consent issues. Further chapters deal with endovascular treatment in particular arterial territories, and include the evidence in favour of or against the use of specific treatments. The most up-to-date evidence surrounding endovascular aneurysm repair is discussed. There are also chapters on venous interventions, including the endovascular management of varicose veins. This book will be of value both to interventional radiologists and to vascular... |
| © 2009 BrightSurf.com |