Quick surgery after mild heart attack does not help: study

May 21st, 2009 - 12:58 pm ICT by IANS  

Toronto, May 21 (IANS) Does rushing a patient to hospital after a mild heart attack improve his or her chances of survival? It doesn’t help much, says a new Canadian study led by Indian-origin professor Shamir Mehta at McMaster University in Hamilton near Toronto.
The study found that rushing patients with a mild heart attack into bypass surgery or angioplasty did not improve their chances of survival, than waiting a few days.

Led by Mehta, the researchers found similar rates of death or recurrence of heart attack in patients who underwent surgery quickly after a mild stroke and those who had to wait for a day and longer.

However, patients at high risk of having another stroke or heart attack needed quick surgery, the researchers said.

Calling their findings “good news for patients and physicians”, Mehta said: “While we have known for a long time that patients with a full blown heart attack benefit from receiving angioplasty as early as possible, we did not know the optimal timing of angioplasty in patients with threatened or smaller heart attacks.”

“These second group of patients represent a large burden to the health care system and outnumber patients with full blown heart attacks by about 2:1. They often respond well to initial therapy with aspirin and other anti-clotting medications.”

As part of their multi-country study, the researchers picked up 3,031 patients - from 17 countries - who underwent angiography within 24 hours of being admitted to hospital or within 50 hours of admission.

Six months after the surgery, 9.6 percent of patients who received early treatment suffered another heart attack or died as compared to 11.3 percent who received delayed surgical intervention.

The study said: “Early intervention did not differ greatly from delayed intervention in preventing the primary outcome, but it did reduce the rate of the composite secondary outcome of death, myocardial infarction, or refractory aeschemia and was superior to delayed intervention in high-risk patients.”

Mehta said: “Patients coming to hospital with small or threatened heart attacks can be treated with aspirin and other anti-clotting medications and be transferred to a catheterisation laboratory a few days later, without undue harm.

“For patients with smaller or threatened heart attacks, only those who are at high risk need to have angioplasty early. The majority can be safely treated a few days later.”

The study has been published in this week’s edition of New England Journal of Medicine.

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