Invasive treatment better for heart attack patients presenting late

Reported by Susan Aldridge, PhD, medical journalist

Stenting can reduce the severity of heart attack even in patients who come to hospital more than 12 hours after the onset of symptoms.
There are various ways of treating a heart attack and it is already known that reperfusion - restoring the blood flow to the heart - is effective among those attending hospital within 12 hours of onset of symptoms. In fact, the earlier treatment with clot-busting drugs begins, the better. However, it has long been assumed that reperfusion is not effective for patients presenting to the hospital 12 hours after their symptoms start.

A team in Munich, Germany, has been looking at what can be done for patients who present late, other than giving them conventional drug treatment. They looked at 365 patients with heart attack, admitted to hospital between 12 and 48 hours after their symptoms began. They were treated either with stenting and the drug abciximab or with conventional treatment, including heparin. In stenting, the blood flow to the heart is restored by inserting a wire device into the blocked artery.

The researchers found that the amount of damaged heart tissue was less among those given the invasive treatment. They also had a 33 per cent lower risk of death, further heart attack or stroke, compared to those on conventional treatment. Therefore, stenting should be considered for those presenting late to hospital with a heart attack.

Source
Journal of the American Medical Association 15th June 2005 Volume 293 pages 2865-2872