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Published: Tuesday, 5/8/2007

Tough love for the heart

NEW research into the effects of aggressive treatment for heart attack patients has stunned even the researchers. It turns out that with vigorous treatment, the percentage of patients who die in the hospital or who later develop heart failure can be cut dramatically. The lesson to be learned should be obvious.

A six-year study of 45,000 patients in 14 countries in the Americas, Europe, and Australia and New Zealand was the largest of its kind. It found that the use of cholesterol-lowering drugs, powerful blood thinners, and angioplasty meant patients were less likely to have another heart attack within six months.

Major heart attack patients showed even better results toward the end of the study, which concluded in 2005. It's believed they fared better because their treatment was improved. The study's primary author, Dr. Keith Fox, a cardiology professor at the University of Edinburgh, said the findings were "much more dramatic than we expected." At the end of the study, they also found that just half as many heart attack patients died in hospitals, that half the number of patients were experiencing heart failure, and that half as many had another heart attack - compared to 1999.

Obviously, this is encouraging, but it has taken a lot of pushing to get some doctors to aggressively treat heart attack patients. In 2001, the American Heart Association urged doctors to treat patients according to guidelines based on the most recent scientific findings. Two years ago, hospitals were docked 2 percent of Medicare reimbursements when they failed to report the percentage of patients getting treatment based on the guidelines.

What all this means is that patients suffering major heart attacks must be vigorously treated as soon as possible. It's regrettable when patients delay going to the hospital. But it's even more so when patients who can benefit from lifesaving treatments don't get them at all.



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