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Treatment for heart attack patients is improving

Access for primary angioplasty varies from 5% to 93%, says report

Adrian O'Dowd

Thursday, 01 September 2011

Treatment for patients with a heart attack is improving with more people than ever receiving the ideal approach of primary angioplasty following their attack. 

The latest MINAP (Myocardial Ischaemia National Audit Project) audit published today shows that in England between April 2010 and March 2011, the number of patients receiving primary angioplasty rose from 63% to 82% compared to the previous year. 

In Wales the number rose from 22% last year to 30%, and in Belfast from 59% to nearly all patients – 99%.

The report’s authors said that 11 years since the start of the national clinical audit for the management of heart attack, most patients in the UK now have primary angioplasty (the damaged artery opened with a balloon catheter) rather than receive clot-busting drugs. 

Access, however, remained extremely variable with the percentage of patients in English cardiac networks that received primary angioplasty ranging between 5-93%. 

In six cardiac networks, less than half of patients received primary angioplasty, while in the two Welsh cardiac networks 2% and 32% of their patients received primary angioplasty.  

The MINAP audit is commissioned by the Healthcare Quality Improvement Partnership and run by the National Institute for Cardiovascular Outcomes Research, part of the National Centre for Cardiovascular disease Prevention and Outcomes within the UCL Institute of Cardiovascular Science. 

Heart attack is common and remains a major cause of death and ill health in the UK, but good treatment coupled with cardiac rehabilitation helps towards full recovery. 

Primary angioplasty is the preferred treatment for heart attack if it can be provided promptly.  

There has been a year on year fall in the percentage of patients with heart attack that die within 30 days of admission to hospital. 

The MINAP audit also measures the time from arrival at hospital to receiving treatment, and the time from calling for professional help. 

This year’s results showed that 90% of eligible patients in England, 68% in Wales and 87% in Belfast were treated with primary angioplasty within 90 minutes of arrival at the heart attack centre. 

Dr Clive Weston, clinical director of MINAP, said: “During the past decade, MINAP has documented major changes in the care provided to people who suffer heart attack. 

“What has not changed in that time is the commitment of individual clinicians, managers and administrators who, through their participation in MINAP, continue to promote the values of national clinical audit – to compare their performance against nationally-agreed best practice, and so to assure and enhance the quality of that care. The remarkable improvement in survival after heart attack bears testimony to their efforts.” 

Public health minister Anne Milton said: “It is good news that more people than ever before are getting primary angioplasty following a heart attack. 

“Last year, 90% of patients in England were treated promptly on arrival at a heart attack centre. This shows that by making small changes the NHS can deliver better, safer and more effective treatment and get better outcomes for patients. However, more needs to be done to improve access to primary angioplasty further.”

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