Clot-busters improve long-term survival
August 1, 1998 less than 1 minute read
Clot-busters improve long-term survival
To greatly improve chances for a good recovery from heart attack, say researchers, get patients to the hospital as soon as possible. New evidence shows that opening vessels immediately significantly improves survival rates beyond the first 30 days.1
Short-term benefits were known, but this study is the first to demonstrate long-term survival. Most people who die of a heart attack do so in the first 24 hours. Reperfusion is critically important to preserving the heart's main pumping chamber.
"Successful early reperfusion provides patients with an advantage that continues to increase well beyond the first month after a heart attack," wrote lead author Allan Ross, MD, director of the Cardiovascular Research Institute at George Washington University in Washington, MD. Although cost analysis was not a component of this study, the substantial additional later benefits should be taken into account in consideration of the cost-effectiveness of aggressive treatment strategies.
Preserving the function of the left ventricle through early emergency treatment saved nine lives per 100 in the first month and two more in the first two years following the heart attack when compared to those who did not have preserved function. Of patients with good ventricular function, 3.1% died in the first 30 days compared to 12% for those with inadequate functioning. The cumulative two-year death rate was 7.2% vs. 26.6%.
Reference
1. Ross AM, Coyne KS, Moreyra E, et al, for the GUSTO-I Angiographic Investigators. Extended mortality benefit of early postinfarction reperfusion. Circulation 1998;97:1549-1556.
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