Invasive procedures may not improve survival after heart attack

Reported by Susan Aldridge, PhD, medical journalist

Patients admitted to hospitals with specialist cardiac equipment do not always do any better after a heart attack, says a new study.
There is an increasing trend towards using cardiac catheterization after a heart attack. This involves passing a thin tube - a catheter - into the heart to investigate the damage. It requires admission to a hospital with specialist equipment.

Now a team in Leuven, Belgium, reports that the high-tech way may not be superior after all. They surveyed 28,000 patients in 14 countries admitted to hospital with suspected heart attack. Around 77 per cent were admitted to a hospital with catheterization equipment. This group was more likely to undergo an invasive procedure like cardiac catheterization than those admitted first to a general hospital with no specialist equipment.

However, comparison showed the risk of death at six months was 14 per cent higher when a patient was admitted first to a specialist hospital. The risk of major bleeding and stroke was also higher. This does not mean that cardiac catheterization is dangerous, but maybe it need not be used routinely. The priority with a suspected heart attack should be to get the patient to the nearest hospital, whether or not it has specialist facilities.

Source
BMJ Online First (bmj.com) 20th February 2005