and Medicine for Seniors
More Heart Attack Victims Saved with Faster Response
of Coordinated Effort
Collaboration between paramedics and hospitals in
treating heart attack patients resulted in shorter emergency department
wait times that result in better survival.
19, 2014 – Virtually all senior citizens know that when a heart attack
strikes, the faster the victim receives medical attention, the better
the chances the patient will survive. A report released today about a
coordinated emergency response system proves faster care can save
thousands of lives and that it is possible to speed up the rescue
The project focused on ST segment
elevation myocardial infarction (STEMI), the type of heart attack that
occurs when a vessel supplying blood to the heart is suddenly and
completely blocked. Quickly opening the blocked artery can restore
normal blood flow and minimize heart damage.
Nearly half of the more than
250,000 people who have a STEMI each year in the United States aren’t
treated within the recommended 90 minutes.
The report on the Regional Systems
of Care Demonstration Project: Mission: Lifeline STEMI ACCELERATOR was
presented today at the American Heart Association’s Scientific Sessions
The project - one of the largest
systems of care efforts to improve heart attack care - included 16
metropolitan areas comprising about 10 percent of the U.S. population.
Researchers tracked more than
24,000 heart attack patients across 484 hospitals and 1,258 emergency
medical services (EMS) agencies during the implementation phase of the
project July 1, 2012-March 31, 2014.
Health-care leadership teams across
the regions established standard treatment protocols, a universal data
collection system and ongoing measurement and feedback to rapidly
diagnose and treat heart attack patients.
In the first 12 months of the
● Patients arriving by EMS
treated within 90 minutes of first medical contact increased from 54
percent to 59 percent (p = 0.0046).
● Some regions improved more than
“The key to success was the
collaboration between paramedics, hospital teams and interventional
cardiologists working to provide care quickly,” says Christopher
Granger, M.D., senior author of the study and director of the cardiac
intensive care unit at Duke University Medical Center in Durham, North
“With in-the-field diagnosis and
activation of hospital catheterization laboratories prior to hospital
arrival, time spent waiting in the emergency department for the
catheterization team to be available was minimized.”
Shorter emergency department (ED)
times (adjusted for several covariates) were associated with improved
survival (p< 0.001):
● The death rate was 3.6 percent
for patients in the ED 30 minutes or less.
● The death rate increased to 7.0
percent for patients waiting in the ED 30-45 minutes.
● Those waiting in the ED longer
than 45 minutes had a 10.8 percent death rate.
The American Heart Association
created Mission: Lifeline in 2007 to bring together hospitals, emergency
medical services and communities to overcome delays in treatment.
Mission: Lifeline STEMI now includes 827 community-based systems,
covering 82.5 percent of the U.S. population.
The American Heart Association and
regional and national leaders led the ACCELERATOR initiative,
coordinated through Duke University, with the Duke Clinical Research
Institute as the coordinating center.
“These findings validate the
concept that the collaborative systems of care model we launched with
our Mission: Lifeline initiative seven years ago can speed heart attack
treatment and save lives,” said Alice Jacobs, M.D., AHA past president,
original chair of the AHA Mission: Lifeline Advisory Working Group and
professor of medicine and Vice Chair for Clinical Affairs, Department of
Medicine at Boston University Medical Center.
“Lessons from the demonstration
project can be used to guide our future efforts to further improve heart
attack care in the U.S. and beyond.”
Co-authors are James G. Jollis,
M.D.; Matthew W. Sherwood, M.D., M.H.S.; Hussein R. Al-Khalidi, Ph.D.;
Mayme L. Roettig, R.N. M.S.N.; Claire C Corbett, M.M.S., N.R.EMT-P.;
Harold L Dauerman, M.D.; Kathleen Fox, R.N., B.S.; J. Lee Garvey, M.D.;
Timothy D Henry, M.D.; Ivan C Rokos, M.D.; B. Hadley Wilson, M.D.;
Author disclosures are on the manuscript.
The Medicines Company, AstraZeneca,
Philips Healthcare and Abiomed funded the study.