Study points to failures in heart attack care in England and Wales

Around 33,000 deaths could have been avoided if heart attack aftercare guidelines outlining when to give treatment were followed, according to a study funded by the British Heart Foundation (BHF) looking at the frequency of missed opportunities to treat people after a heart attack. A BHF-funded team of researchers from UCL and the University of Leeds used data from the UK National Heart Attack Register to analyse the 389,057 cases of non-ST elevation myocardial infarction (NSTEMI), the most common type of heart attack, in 247 hospitals in England and Wales between 1^st Jan 2003 and 30^th Jan 2013. The researchers looked at 13 treatments that guidelines recommend be considered for patients who have suffered from an NSTEMI, where blood supply to the heart is limited rather than completely cut off. They assessed how often these treatments were given and compared this with whether guidelines at that time suggested that they were appropriate. Almost 87 per cent of patients did not receive at least one of the interventions that they should have been given. The most frequently missed were dietary advice, advice to help people to stop smoking and the prescription of a type of anticlotting drug known as P2Y12 inhibitors, such as clopidogrel. The team also looked at the effect that these missed interventions had on the health of the patients within the study.