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Heart attack care in Sweden superior to UK

September 02, 2019

People suffering from heart attacks in Sweden were less likely to die from them in the short and long-term than those in England and Wales, according to a new study.

Researchers, led by the University of Leeds, have for the first time compared the care of the entire populations of Sweden, England and Wales, revealing the superior quality of care in the Scandinavian state.

Lead author Dr Oras Alabas, from the University of Leeds' School of Medicine, said: "Whilst Sweden and the UK both have high performing nationwide health systems, these results demonstrate that there are still improvements to be made when caring for heart attack patients.

"Our findings suggest that the increased use of invasive treatments and recommended medications in Sweden could be causing these differences in mortality.

"The NHS generally does a very good job of looking after heart attack patients, but this data suggests we can build on this great care by learning from our European neighbours."

Their study, published in the journal Cardiovascular Research, compared the treatment and outcomes of over 180,000 patients in Sweden to over 660,000 patients in the UK.

They found that patients who experienced the most severe form of heart attack, known as STEMI, had a net probability of death, defined as the probability of dying due to heart attack and not from other causes, of 6.7% in Sweden compared to 8.0% in the UK, in the one-month following their heart attacks. There was no difference in mortality due to their heart attack from one year after the event onwards for STEMI patients in Sweden compared with the UK.

For the less severe form of heart attack, called NSTEMI, they found that in the following one month from the onset of heart attack, patients from Sweden had a net probability of death of 4.9% compared to 6.8% for those from the UK. The net probability of death from one year after the heart attack onwards was 18.3% for patients in Sweden compared with 21.4% for patients in the UK.

The probabilities are not an individual's probability of dying, but the probability that if they die it was because of their heart attack, and not a different cause of death.

These probabilities therefore indicate how likely it is that a particular health problem will be an individual's cause of death, and thus how well patients are being treated for their heart attacks.

Co-author Professor Chris Gale, from the University of Leeds, said: "Population-based international research is a critical next step if we are to improve how we care for patients with cardiovascular disease.

"This study clearly shows that whilst the NHS is delivering very good care for patients with heart attack, improvements can still be made, which will result in a reduction in potentially avoidable deaths."

University of Leeds

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