Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 32 n° 220

Posts Tagged ‘heart attacks’

Weekend heart attacks twice as likely to kill young patients

Posted by fidest press agency su lunedì, 5 marzo 2018

Milan, Italy Young heart attack patients are twice as likely to die if they are admitted to hospital during the weekend compared to a weekday, according to an Italian study in more than 80,000 patients presented today at Acute Cardiovascular Care 2018. “Excess deaths at weekends were reported for heart attack patients a decade ago2 and we wanted to see if the situation had improved,” said lead author Dr Giovanni Malanchini, resident in cardiology at the University of Milan, Italy, under the supervision of Professor Federico Lombardi. “We also looked at whether there were differences by age or sex.” The study included all 80,391 patients with an acute coronary syndrome3 admitted to a hospital in the Lombardy region of Italy for less than 20 days between January 2010 and December 2014. Age and sex data were collected from discharge charts. The primary outcome of interest was in-hospital mortality.Patients, on average, were 67 years old, and 70% were men. A total of 2,455 patients (3%) died while in hospital.When all patients were analysed, the researchers found a 13% higher risk of death in those admitted at weekends compared to weekdays.Dr Malanchini said: “We analysed data from the Milan area, which provides some of the best treatment for heart patients in Italy. Yet even here we are not delivering the best care every day of the week.”The researchers then analysed outcome according to different age cut-offs (under 45, 55, 65, 75, and over 75 years). They found that the risk of dying during a weekend admission got progressively greater as age declined (see figure). Patients under 45 had a more than two-fold risk of dying at the weekend, while the excess risk in the over-75s was just 5%.Professor Lombardi said: “This is a new finding, that younger heart attack patients are particularly vulnerable to the excess mortality linked to weekend admissions.” Men and women were then analysed separately. The researchers found that men admitted on any day of the week with an acute coronary syndrome had a 15% lower risk of death than women. Men were more susceptible to the ‘weekend effect’, with a 15% increased of death compared to 11% for women.The observational study did not examine the reasons for the excess mortality at weekends, and the causes are likely multifactorial. But authors said that patients admitted at weekends may have to wait longer for reperfusion therapy to open occluded arteries and restore blood flow.“The delay in reperfusion during weekends may be more important in younger patients,” said Dr Malanchini. “This is usually their first acute coronary syndrome and they are not receiving aspirin, drugs to lower cholesterol (statins), or drugs to lower blood pressure (angiotensin converting enzyme inhibitors and beta-blockers). This could make them more vulnerable.” Professor Lombardi said: “The belief that heart attacks are a ‘man’s problem’ may contribute to a longer gap between symptoms and treatment in women every day of the week, with a resulting higher mortality.” (graphic: hospital mortality)

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European standards to prevent repeat heart attacks launched today

Posted by fidest press agency su giovedì, 8 settembre 2016


Sophia Antipolis. European standards to prevent repeat heart attacks are published today in the European Journal of Preventive Cardiology.1 The standards were defined by the European Society of Cardiology (ESC).2“Cardiovascular disease (CVD) is the world’s number one killer, accounting for one in five deaths in Europe,” said lead author Professor Massimo F. Piepoli. “The biggest consequence of CVD is myocardial infarction (heart attack).” He continued: “One in five people who survive a heart attack have a second cardiovascular event in the first year – even when receiving optimal treatment and care. The people behind these numbers spurred this call for action to reduce the risk.” The consensus document outlines the steps patients and healthcare professionals can take to prevent recurrent heart attacks. “A heart healthy lifestyle is the most effective way to avoid another heart attack,” said ESC prevention spokesperson Professor Joep Perk. “This should be supported with good medical treatment and follow up.”
Steps to prevent repeat heart attack:
1. Quit smoking
2. Do regular physical activity
3. Eat healthy food
4. Take prescribed medication to protect coronary vessels, and to control risk factors such as high blood pressure and cholesterol
“Stopping smoking beats everything for preventing heart attacks,” said Professor Perk. “Combine that with exercise and a healthy diet and we could avoid 80% of all myocardial infarctions.” According to the EUROASPIRE survey, after an acute myocardial infarction 16% of patients smoke, 38% are obese and 60% report little or no physical activity.3 Only half of patients are advised to participate in a cardiac rehabilitation programme, of whom just 80% actually attend. European guidelines on CVD prevention outline blood pressure and cholesterol targets but these are still missed. “Having a heart attack is an upsetting experience but it does not seem to motivate patients to adopt a healthy lifestyle to avoid having another one,” said Professor Piepoli. “We also know that more than half of heart attack patients stop taking their preventive medications.” “Patients are almost blinded by the excellent results of stents to clear blocked arteries,” said Professor Perk. “There is an over-belief in what medical care can provide and patients feel they don’t have to do anything. The challenge is to convince patients that the best way to prevent another heart attack is to take responsibility for their own health. Many lives could be saved – there is too much to lose by not doing it.” Prevention of recurrent heart attacks should begin immediately after the first event, while patients are still in hospital. This should be given equal priority to treating the initial heart attack. Patients should be referred to an outpatient cardiac rehabilitation to reinforce lifestyle messages and encourage adherence to behaviour change and medications. Professor Piepoli said: “Acute cardiovascular care specialists are responsible for identifying risk factors (smoking, inactivity, poor diet) and teaching patients how to improve their lifestyle habits. This can be supported by prescribing medicines for high blood pressure and cholesterol. Failure to start prevention as early as possible may give the erroneous impression that it is less important than the cure.” He concluded: “We have scientifically proven ways to prevent second heart attacks. But we need to empower patients to better understand their risk factors after myocardial infarction and take a central role in their recovery. Cardiologists, nurses and allied professionals all have a role to play in prevention, starting in the acute phase through to follow up care after hospital discharge.”

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