Heart attack survival 'significantly lower' in UK than Sweden
A new study published in The Lancet has questioned the care of heart attack patients in the UK - stating that the chance of surviving a heart attack in the country is significantly lower than in Sweden.
Researchers say if the UK had adopted the same health care strategies as Sweden, more than 11,000 heart attack deaths may have been prevented.
The research team, including Prof. Harry Hemingway of University College London in the UK and co-leader of the study, says that their findings are "a cause for concern."
They stress that further international comparisons of health care policy and clinical practice may lead to improvements in the quality of health systems and prevent more heart attack deaths.
To reach their findings, the investigators analyzed data from national clinical registries of patients who had suffered a heart attack between 2004 and 2010.
Included in the data were 391,077 patients from 242 hospitals in the UK, alongside 119,786 patients from 86 hospitals in Sweden.
The analysis revealed that 30 days following a heart attack, 10.5% of UK patients died, compared with 7.6% of Swedish patients.
Researchers say that if the UK had adopted the same health care strategies as Sweden between 2004 and 2010, over 11,000 heart attack deaths may have been prevented.
The investigators say that the difference in death rates reduced over time but the mortality rate was consistently higher in the UK.
The research team then adjusted the results after taking 17 patient variables into consideration. These included age, sex, severity of heart attacks, whether patients smoked and whether they had diabetes.
This led the investigators to estimate that over the 7 years of the study, if UK patients had received the same care as Swedish patients, 11,263 deaths could have been prevented or delayed.
"We found greater mortality among patients with acute myocardial infarction (heart attack) in the UK than similar patients in Sweden," the researchers say. "The differences in the care and outcomes of acute myocardial infarction are a cause for concern."
Sweden had 'greater uptake of effective treatments'
The analysis revealed that during the 7-year study period, there had been a significantly higher uptake of primary percutaneous coronary intervention - procedures such as stent placement or balloon angioplasty to widen narrowed arteries - in Sweden, compared with the UK.
Furthermore, in Sweden there was a higher rate of prescribed medications, such as beta blockers, when patients were discharged from the hospital.
Dr. Tomas Jernberg, of the Karolinska University Hospital in Sweden, also notes that quality registries - databases that continuously gather health care information, including data on treatments and patient outcomes - have increased the ability of health care professionals in Sweden to adhere to guidelines.
"Our findings suggest that failure to get the best treatment is one likely reason why short-term survival for heart attack patients is lower in the UK."
New research strategies needed to improve health systems
Based on these findings, the research team concludes that a "novel research agenda" is needed in order to improve the quality of health systems, and they suggest comparing international data on quality of care and patient outcomes may help.
In a comment article linked to the study, Chris Gale, of the University of Leeds, and Keith Fox, of the University of Edinburgh, both in the UK, say that by finding the UK has a significantly higher rate of heart attack deaths compared with Sweden, the investigators have highlighted the need for more comparative research.
"Efforts to improve cardiovascular outcomes in the UK should, therefore, concentrate on data enhancement through the linkage of electronic health care records and the early and systematic implementation of evidence-based therapies across the National Health Service," they add.
In other news, Medical News Today recently reported on a study detailing how a new blood test may accurately predict the risk of heart attack.
Written by Honor Whiteman
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