Angioplasty Should be the Standard

A new study finds angioplasty should be the treatment of choice for heart attack patients, even if the hospital they initially go to doesn't offer angioplasty services and they have to be transferred to another facility for treatment.

Research has shown heart attack patients fare better when they are treated with angioplasty to open up the clogged blood vessel that caused the attack than when they are treated with a clot-busting drug therapy called fibrinolysis.

Danish investigators provide evidence reversing conventional wisdom. Their study involved around 1,500 heart attack patients at 24 hospitals without angioplasty services and five hospitals with such services. Patients at the 24 hospitals were randomly assigned to either treatment with fibrinolysis at the facility where they were first admitted or treatment with angioplasty at another hospital that offered the service, if they could be transferred to the new hospital within two hours.

Researchers analyzed results, looking at a combination of death, clinical evidence of another heart attack (reinfarction), or a disabling stroke within 30 days. Results showed patients who received angioplasty were significantly more likely to survive, regardless of whether they had been transferred to another hospital to receive the angioplasty or not. Overall, only 8.5 percent of the angioplasty group suffered a complication, compared to 14.2 percent of those in the fibrinolysis group. The primary benefit was a reduction in the rate of reinfarction among the angioplasty patients. Little difference was noted between the groups in death or stroke rates.