Today, the Irish Heart Foundation welcomes the Irish Heart Attack Audit National Report 2021 by the National Office of Clinical Audit (NOCA).

A heart attack is a life-threatening event that happens when the coronary arteries that supply blood to your heart muscle suddenly become blocked. A STEMI (ST Elevated Myocardial Infarction) is generally a more serious type of heart attack, where the risk of complications and death without timely and appropriate medical intervention is very high. STEMI is thought to represent one quarter of all heart attacks in Ireland each year.

In Ireland, heart disease is a leading cause of death for both men and women.

The report was undertaken with 1,491 patients who had experienced a STEMI heart attack and had received treatment in a percutaneous coronary intervention (PCI) centre during 2021. 77% of those patients were male with a median age 61 and 23% were female with median age 67.

82% had at least one known cardiovascular risk factor, while 46% had high cholesterol, 44% had high blood pressure and 39% were smokers at the time of their heart attack.

According to the report, only 44% of patients called 999/112 for help within 60 minutes of onset of symptoms. However, time matters and calling an ambulance immediately will give the best chance of survival and quality of life following a heart attack. The paramedic will use an ECG machine to diagnose the heart attack and bring you to the nearest PCI centre to receive treatment. Patients will be twice as likely to be treated within the recommended time.

Heart attack symptoms can be different for men and women and include: chest pain, upper body pain in jaw, back, neck or arms, shortness of breath, sweating, nausea, light-headedness, loss of consciousness, weakness or tiredness.

The report makes four key recommendations:

• Develop a public awareness campaign to encourage people with heart attack symptoms to call 112 or 999 immediately for emergency help in order to facilitate pre-hospital electrocardiogram (ECG) diagnosis of a STEMI.
• There should be a national and regional focus on quality improvement in the STEMI care pathway.
• Improve public awareness of the adverse impact of smoking on heart attack risk.
• Support patients with STEMI to reduce the risk of further heart attack by increasing the rate of referral to cardiac rehabilitation phase 3. The report found that only 66% of those eligible for cardiac rehab were referred for treatment, despite their being a 90% target. In addition, the report found that only 74% of patients were receiving the appropriate secondary prevention medication despite a target of 90% being set. While speaking at the launch of the report, Pauline O’Shea, Advocacy Campaign Manager with the Irish Heart Foundation said, “Separate messaging around these findings also needs to be offered to professionals involved in treating STEMI’s, such that referral pathways to cardiac rebab, and to other supports that can assist with lifestyle changes to support these patients avoid a secondary event.”

Pauline O’Shea, Public and Patient Interest Representative, remarked “As a heart attack patient, and as the Advocacy Campaign Manager with the Irish Heart Foundation who represents cardiac patients, I hugely welcome this NOCA audit work, but have some real concerns in relation to some of the findings it reveals. Lack of public messaging around the significance of time and ambulance pre-hospitalisation care in relation to outcomes for patients, could literally be costing patients’ lives and survivors quality of life. We also need to look at the shortfalls in service delivery this report reveals, as compared with the targets set. Heart attack is a huge issue in Ireland, so we really need to have good public messaging, and good service delivery to ensure we can offer best outcomes for patients.

The NOCA Irish Heart Attack Audit National report 2021 and summary, can be viewed here