Recent studies produced misleading results because doctors tend to send the sickest patients to have the best care, according to new research.
Recent studies questioning the role of specialist heart attack centres produced misleading results because doctors tend to send the sickest patients to have the best care, according to new research. Many heart attack patients in the UK are sent to a specialist centre for primary angioplasty - a surgical procedure to reopen the blocked artery. Randomised trials have found that angioplasty is much more successful than drug treatment alone, but research based on "real-world" data suggests that patients given an angioplasty don't tend to do better. Now researchers at Imperial College London have shown that the apparent lack of benefit in the clinical records is due to high-risk patients being more likely to be sent to a heart attack centre, which skews the data. After taking this bias is into account, they find that primary angioplasty reduces the death rate from heart attacks by 22 per cent. They say the findings confirm that heart attack centres play a vital role, and should be made available more widely. The latest figures show that 82 per cent of heart attack patients in England and 30 per cent in Wales receive a primary angioplasty, with wide discrepancies in access between regions.
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