Heart attack treatment: Better late than never

Results from a new study contradict the prevailing notion that heart attacks run their course in less than a day and suggest that even delayed treatment can preserve heart tissue that otherwise would die.

Widely used guidelines for treating heart attacks recommend deploying procedures for clearing blocked heart arteries only if the patient can be treated within 12 hours of the attack’s onset (see “A Matter of Time,” in this week’s issue). In Europe and North America, up to 40 percent of people who have severe heart attacks don’t get to the hospital within that period, says cardiologist Albert Schömig of the German Heart Center at Munich Technical University. Those latecomers traditionally receive only supportive care for their hearts, which are presumed to have been irreparably damaged.

The new study enlisted 365 patients who arrived at any of 16 hospitals in Germany, Italy, and Austria between 12 and 48 hours after their heart attacks began. Schömig’s team treated about half of these patients the traditional way. In the rest, the team performed such procedures as propping open the obstructed artery with a stent.

Diagnostic images made about a week after each attack showed that the latter group had less dead heart tissue than did the group that got standard care, Schömig and his colleagues report in the June 15 Journal of the American Medical Association.