Fewer people dying from major heart attacks thanks to increased access to timely treatment

Fewer people in Ireland are dying from major heart attacks, a new report has found.

‘Heart Attack Care in Ireland 2016,’ which was launched recently by the HSE, found that 1,412 people were treated for a major heart attack or ST Elevation Myocardial Infarction (STEMI ) in Ireland in 2016.

A STEMI is a very serious heart attack in which one of the heart’s major arteries is blocked.

The report found that mortality (death) from STEMI decreased consistently over the previous 4 years from 6.6 per cent to 4.9 per cent in 2016, bringing Irish performance within the European norm.

The report also found that an increasing number of patients received appropriate treatment in a more timely manner for their heart attack. This treatment is called PPCI.

PPCI is a procedure to remove a clot and put a stent into the blocked coronary artery that has caused the heart attack and it is the main treatment for ST Elevation Myocardial Infarction (STEMI / heart attack) in Ireland).

Of the 1,412 people who were treated for a major heart attack, 96 per cent of eligible patients received PPCI. The vast majority or 82 per cent of these patients received rapid PPCI treatment within 120 minutes of arrival directly at a specialist PPCI centre compared to 77 per cent in 2014. However, the report also found that timely PPCI treatment was achieved in just 41 per cent of patients who were transferred from another hospital.

The report also highlighted improvements that took place in the pre-hospital setting in 2016 which included an increase in the number of positive ECGs (tests used to diagnose a heart attack) (47.3%) undertaken prior to arrival at hospital compared with 2014 (41%).

The location of the first positive ECG was either in the ambulance (47.3%) or in the Emergency Department (41.1%) with 5.9% in General Practice and 5.9% in other hospital locations. The proportion of first positive ECGs undertaken in the ambulance in 2016 was significantly increased on 2014 which denotes a shift to greater pre-hospital detection and diagnosis, the report found.

People who are most at risk of a heart attack are people over 50, smokers, over-weight, people with known cholesterol issues / blood pressure and those with a strong family history.

The report found that 38 per cent of STEMI patients were smokers however just two out of three smokers were given support to stop smoking.

According to the report, “while smoking levels are high in STEMI patients, documentation of smoking cessation counselling occurred in only two out of three smokers. This is an area that would benefit from scrutiny as helping the patient to quit smoking is essential and is as important as other treatment measures. Initially it is important to clarify if this is an issue of incomplete documentation or a real reduction in attention to helping smokers to quit? Notably levels of smoking in those who presented with recurrent STEMI is also high as is smoking among patients with diabetes. As all of these patients have had multiple exposures to healthcare staff the question is – can we do more to help these patients to quit?”

Speaking at the launch of the report, Dr Siobhan Jennings, Consultant in Public Health Medicine, outlined the importance of smoking cessation counselling in PPCI centres. “Smoking levels are high in STEMI patients (38%), so helping a patient to stop smoking is essential and is as important as other treatment measures. It is never too late to quit smoking, I would encourage all smokers not to wait another day and to visit www.quit.ie”.