Today, the National Office of Clinical Audit launched the Irish Heart Attack Audit National Report 2022 and 2023.

The report reveals the key quality indicators in the care provided to the patients who experienced a major heart attack known as an ST elevation myocardial infarction (STEMI). A STEMI happens when the supply of blood to the heart is suddenly cut off, usually by a blood clot (thrombosis). Key statistics regarding the lifestyle factors and treatment of those patients was also audited.

Receiving timely treatment is important for patients, and the report revealed that of the 3,102 patients treated in one of the ten primary percutaneous coronary intervention (PCI) centres in Ireland, 55% were brought directly by ambulance to a PCI centre. 32% of patients were transferred from a non-specialist hospital to a PCI centre.

The audit continues to show that the likelihood of achieving timely treatment is highly dependent on how a patient accesses a primary PCI centre. Patients who arrive directly at a PCI centre, usually by ambulance and after having the diagnosis confirmed by a pre-hospital ECG with the ambulance service, receive timely treatment in 79% of cases compared to 45% of those who are transferred from another hospital.

Pauline O’Shea, Patient and Public Interest Representative on the IHAA Governance Committee and Advocacy Campaign Manager with the Irish Heart Foundation, commented, “The audit clearly shows, year on year, the impact of the initial transport choice for many patients having a heart attack is significant in terms of quality and quantity of life after a heart attack.”

According to the report, only 49% of patients called for help within one hour of onset of symptoms, an increase from 44% in 2021. The report calls for a national public awareness campaign to educate the public on recognising the early symptoms of a heart attack and the importance of calling emergency services to help diagnose a STEMI heart attack promptly with a pre-hospital ECG and bring the patient to the right hospital at the right time.

Dr Angie Brown, Consultant Cardiologist and Medical Director with the Irish Heart Foundation said: “The Irish Heart attack audit is important as it demonstrates the worrying fact that though there has been an improvement unfortunately still only 49% of people called for help within an hour of the onset of symptoms. Furthermore 35% of patients were smokers at the time of their heart attack, this is almost three times the rate of smoking nationally (13%). Current smokers present with heart attack on average 10 years younger than those who have never smoked.”

Of the 3,102 patients, 77% were male with a median age of 62 years and 23% were female with a median age of 69 years.

66% of patients received timely treatment to restore blood flow (known as reperfusion) in 2023, which is below the target of 90%. 7% received treatment with thrombolysis, a medication to dissolve clots.

Secondary prevention was targeted by way of prescribing medication to 86% of patients with a STEMI and 91% of patients were referred to cardiac rehabilitation. Smoking, high cholesterol and high blood pressure were highlighted as risk factors of heart attack.

Dr Ronan Margey stated, “While we celebrate the improvements seen in this report, there is still work to be done to ensure timely intervention for all patients. We are committed to continuing our efforts to improve outcomes for patients with a heart attack across the country.”