The report is the eight public report from the Myocardial Ischaemia National Audit Project (MINAP). It presents analyses from all hospitals and ambulance services in England and Wales that provided care for patients with suspected heart attack from April 2008 to March 2009, and compares these with the previous year. Among other things the report shows an increased use of PCI and improvement in delivering thrombolytic treatment within 60 minutes of a call for help.
(Extract from executive summary)
This is the Eighth Public Report from the Myocardial Ischaemia National Audit Project (MINAP) on the treatment of heart attack patients. It presents analyses from all hospitals and ambulance services in England and Wales that provided care for patients with suspected heart attack from April 2008 to March 2009 (2008/9), and compares these with the previous year (2007/8). The analyses are based on data available at 5 June 2009.
Heart attack, or myocardial infarction, is part of the spectrum of conditions that cardiologists refer to as acute coronary syndrome (ACS). The term ACS covers both heart attacks for which emergency reperfusion treatment with thrombolytic drugs or primary angioplasty is used (ST elevation infarction) and those commonly referred to as non-ST segment elevation myocardial infarctions, for whom different treatment is used. Non-ST segment elevation infarction represents the majority of heart attacks. In previous years this report has tended to focus only on the group that receive reperfusion treatment, but this year, and in future, we also analyse care for non-ST segment elevation infarction.
High quality care for ST segment elevation myocardial infarction (STEMI) includes early
diagnosis and rapid treatment to re-open the blocked coronary artery responsible for the heart attack. This has until recently been achieved mainly with clot dissolving drugs (thrombolytic treatment) followed by the prescription of drugs that reduce the risk of further heart attack (secondary prevention medication). National and international guidelines recommend primary angioplasty as the preferred treatment where it can be provided promptly and increasing numbers of patients now benefit from this treatment. During 2009 the use of primary angioplasty will exceed that of thrombolytic treatment for the first time in England and Wales.
As the number of patients having primary angioplasty increases, the number having thrombolytic treatment will fall. However this report shows a continuing improvement in the percentage of patients receiving thrombolytic treatment within 60 minutes of a call for help. The number having treatment before reaching hospital has fallen in line with the overall decrease in use of thrombolytic treatment.
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