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Heart Attack Patients Twice as Likely to Receive Emergency Stenting Treatment in 24/7 Hospitals

A 10-year study, led by the University of Leeds, has revealed wide variations in the way hospitals in England give emergency treatment to patients following a major heart attack.

The research, which looked at 300,000 patients across 84 English hospital trusts, showed that heart attack patients are twice as likely to receive life-saving stents to open blocked coronary arteries in hospitals that provide a seven-day service.

The study also found patients were 30 per cent more likely to receive stents in hospitals that have more than five cardiologists specifically trained in the procedure. Elderly patients or those who had previously suffered with a heart attack, angina, heart failure or diabetes were less likely to be given the treatment.

The Procedure

Emergency stenting treatment is given via ‘primary percutaneous coronary intervention’ (PPCI), also known as angioplasty.

The procedure involves inserting a catheter via the groin or arm and threading it through the blood vessels into the coronary arteries of the heart. A balloon at the tip is then inflated to open any blood vessels that have been narrowed by plaque build-up. Once blood flow has been restored, a stent is placed in the arteries to keep them open and the balloon is deflated and withdrawn.

Statistics and Variations

Use of emergency stenting has risen from 0.1 per cent in 2003 to 86 per cent in 2013. People who are given PPCI after having suffered what is known as a ‘Stemi’ (ST-elevation myocardial infarction) - a severe heart attack caused by a prolonged blockage of a coronary artery - are 37 per cent less likely to die than those who are simply given clot-dissolving drugs.

Despite this, the authors of the study said there was no guarantee that all hospitals would use PPCI, and that the key reasons behind 50 per cent of the variations in the way emergency heart attack treatment was given centred around a lack of specially-trained staff and the unavailability of 24/7 PPCI.

The researchers said the remaining variations reveal different standards of care across England and highlight a real need for all heart attack centres to have the facilities and infrastructure required to provide this life-saving treatment around the clock.

The sooner blockages in coronary arteries are opened following a heart attack the better the chances of survival. Since its introduction in the early 2000’s PPCI has helped save thousands of lives and revolutionised the way heart attack patients are treated.

At present, nine out of 10 people who suffer a major heart attack are treated with PPCI. But as this study shows, this procedure is not guaranteed everywhere and there are still cases where the necessary treatment is not being offered because of a lack of staff or expertise.

This is unacceptable, and it is crucial that the NHS ensures there are enough sufficiently resourced heart attack centres around the country that are able to provide the specialist 24/7 care needed to prevent further avoidable loss of life.

Paul Sankey is a senior clinical negligence solicitor at Slater and Gordon in London.

If you or a member of your family suffered from negligent treatment in hospital, call our clinical negligence solicitors for a free consultation on freephone 0800 916 9049 or contact us online.

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