Delayed treatment can worsen heart attack impact

The delay of patients in recognising heart-attack symptoms and seeking the treatment later may increase the damage to heart, warns a new study.

The researchers in this study compared the impact of the time from heart attack symptom onset-to-balloon and door-to-balloon on heart muscle function. "The decrease in median door-to-balloon time in recent years has not resulted in a reduction in mortality in STEMI patients," said study author Roxana Mehran from Mount Sinai School of Medicine in the US.

STEMI or ST-segment elevation myocardial infarction is a full-blown heart attack caused by the complete blockage of a heart artery. "This study highlights the need to reconsider the role of door-to-balloon as a performance metric and examine the utility of a broader metric of systems delay such as first medical contact to balloon time as well as total ischemic time," Mehran added.

Door-to-balloon time is the time from when a heart attack patient arrives in the emergency room until percutaneous coronary intervention is performed to restore blood flow. The researchers reviewed the records of 2,056 patients and compared them with the symptom onset-to-balloon time in three categories - two hours and less, more than two hours to four hours, and more than four hours.

The patients who took two to four hours or longer from the onset of symptoms to get treated to restore blood flow to the heart were less likely to have blood flow fully restored to the heart and were more likely to die within three years than patients treated more quickly, the study found. (The study was published online in the journal of JACC: Cardiovascular Interventions.)