Hospitals Not Using Drugs Fast in Heart Patients
Wed Nov 12,12:25 AM ET Add Health - Reuters to My Yahoo!



ORLANDO, Fla. (Reuters) - Doctors are not using the latest heart drugs in nearly two out of three patients rushed to the emergency room, U.S. researchers reported on Tuesday.

Hospitals also underuse proven lifesaving surgical procedures such as angioplasty, the team at Duke University in North Carolina told a meeting of the American Heart Association (news - web sites).


"Acting quickly with therapies that have been shown to be effective can save lives," said Dr. James Hoekstra, chairman of the department of emergency medicine at Wake Forest University School of Medicine.


"If we stick with the guidelines and utilize all the proven therapies within the first 24 hours, our patients will do better."

Dr. Eric Peterson and colleagues at Duke analyzed data about more than 56,000 U.S. patients who arrived at emergency rooms with heart attack symptoms for their report.


For instance, they found that in the first day, nearly two-thirds of patients were not give a new class of clot-inhibiting drugs called glycoprotein (GP) IIb/IIIa inhibitors. Yet studies have shown that quick administration of such drugs can save lives.


These drugs help stop blood platelets from clumping together into clots.


The in-hospital death rate was 2.7 percent for those who got the drugs the first day, compared to 4.7 percent for those who got them later.


Patients not given the new drugs tended to be older, to have additional health problems, and to have more cardiovascular disease, said the researchers.


"This is one of the paradoxes that we see in medicine, that the patients who would benefit the most from an effective therapy are not receiving it," Peterson said in a statement.


Hoekstra said that the patients who did the best were treated as soon as possible.


"As soon as the patient is identified, we need to treat aggressively with the whole package -- heparin, aspirin, beta-blockers, GP IIb/IIIa inhibitors and catheterization if appropriate," Hoekstra said.


"The timeline of care for these patients is critical. In the old days, many of these patients would be sent from the emergency department to the cardiac care unit to 'cool off' for a few days. Now we know that the key is to start these protocols that have been proven effective right away in the emergency room."


The study was paid for by several drug companies that make heart treatments including Millennium Pharmaceuticals, Schering-Plough Corp, Bristol-Myers Squibb and Sanofi Pharmaceuticals.