More than 90 percent of patients requiring emergency angioplasty are now treated within recommended 90 minutes.
A new study that shows heart attack patients are now being treated on average 32 minutes faster than they were five years ago provides evidence of the success of a national campaign to treat heart attacks within 90 minutes in order to reduce heart damage and costs associated with treatment, said David Holmes, MD, FACC, president of the American College of Cardiology (ACC).
The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90 percent of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44 percent in 2005.
“We are not done. We intend to remain focused on providing training and feedback in the form of data from our registries to maintain these gains while continuing to look for ways to improve,” Dr. Holmes said. “Another piece of the time-to-treatment equation is time lost when patients are transferred in to a referral center. Coordinated systems of care in which patients are taken directly to a hospital equipped to perform angioplasty and insert stents or are transferred quickly are crucial to continued improvement.
“It will also be critical to see how this approach affects outcomes in heart failure, reinfarction, mortality and left ventricular function.”
The study, appearing in Circulation: Journal of the American Heart Association, provides evidence that the ACC’s leadership in the D2B Alliance for Quality is paying off in terms of quicker treatment for heart attacks, resulting in lives saved, better quality of life after a heart attack, quicker recovery and reduced treatment costs, Dr. Holmes said.
“The goal of our D2B campaign is to improve the timeliness of lifesaving therapy for ST-elevation myocardial infarction (STEMI) patients at the nation’s hospitals that perform emergency angioplasty,” Dr. Holmes said. “These remarkable results show that we are on the right track: in five short years we have achieved tremendous improvements in D2B times. This is a true testament to what we can accomplish with an evidence-based approach to quality improvement.”
ACC CEO Jack Lewin, MD, said the D2B experience provides an example that should help shape health policy because it illustrates how evidence-based practice can reduce the cost of healthcare in the long term.
“This report illustrates how campaigns like the ACC’s D2B Alliance can reduce variation and improve patient outcomes and long-term health, with a documented 30 percent reduction in morbidity and mortality from cardiovascular disease over the past decade,” Dr. Lewin said.
“While doctors and hospitals are working together through the use of ACC data and the National Cardiovascular Data Registries to deliver quality care, we have received no incentives or rewards for this amazing progress,” Dr. Lewin said. “Imagine if Medicare and private insurance companies would incentivize the diffusion of our registries and quality improvement tools and programs across the nation. Cardiovascular disease currently represents over 43 percent of Medicare costs, and we could save billions of dollars and millions of lives by applying the science and best practices we have already developed to the entire U.S. healthcare system.”
“The doctors and hospitals in the D2B Alliance receive no financial incentives, even though there are costs to participate. With new partnerships between the Centers for Medicare & Medicaid Services, employers and insurers, we could reduce cardiovascular morbidity and mortality by another 30 percent in the next ten years. Let’s do it.”