Department of Health and Social Care
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New line of defence for heart attacks
Primary angioplasty is set to become the nation's first line of treatment for heart attacks, saving hundreds of lives each year, according to the National Infarct Angioplasty Project (NIAP) final report launched today by the Department of Health.
The NIAP study has concluded that is both feasible and cost-effective to offer angioplasty as an emergency treatment for 97% of the population of England.
Currently, thrombolysis, the injection of life saving clot busting drugs, is the most common treatment for heart attack patients. Primary angioplasty, is widely believed to provide superior outcomes, provided that it can be delivered quickly. Angioplasty is the procedure of inserting, then inflating, a small balloon in the blocked coronary artery, leaving a rigid support to restore blood flow.
Clinical evidence shows that using angioplasty as the main treatment for heart attack patients will:
* Save around 240 more lives per year
* Reduce complications
from treatment of heart attack
* Reduce reoccurrence of heart
attack
* Prevent around 260 strokes per year
* Decrease
the length of stay in hospital for primary angioplasty patients
The NIAP report concludes that 97% of people in England can receive the treatment within acceptable treatment times (120 minutes from call for professional help to treatment). Those who cannot get treatment on time, or those who are unable to have angioplasty for health reasons, will still be treated with early thrombolysis.
Health Secretary, Alan Johnson said,
"The national roll out of the primary angioplasty strategy recommended in the NIAP report will save hundreds of lives each year and improve outcomes for many more heart attack patients.
"The Department of Health's investment in this study reinforces its ongoing commitments to tackling cardiovascular heart disease and using clinical evidence to identify the most effective health services. Compared to 1996, nearly 33,000 lives were saved last year in heart disease, stroke and related diseases and inequalities in the death rate from these diseases have been narrowing for the past eight years.
"Primary angioplasty is at the forefront of clinical innovation and it is a testament to staff and management in the NHS that it can be offered quickly and expertly in specialist centres across the country."
National Clinical Director for Heart Disease and Stroke, Roger Boyle said:
"As well as providing further evidence of the efficacy of angioplasty, this report shows that a primary angioplasty can be offered to heart attack patients in almost all parts of the country. This is a very positive conclusion in terms of improving outcomes for heart attack patients and ultimately saving lives."
NHS commissioners, cardiac network and providers are expected to take forward the report's good practice guidance according to local priorities and in line with Professor Lord Darzi Next Stage Review.
The Department of Health will monitor the extent of rollout and patient outcomes and help clinicians to benchmark progress with clinical performance indicators.
[ENDS]
Notes to editors:
1. For media enquiries only call the Department of Health Media Centre on tel: 020 7210 5221
2. The report is available online at: http://www.dh.gov.uk
3. NIAP is an observational study set up by the Department of Health in collaboration with the British Cardiovascular Society (BCS) and British Cardiovascular Intervention Society (BCIS).
4. The National Service Framework for CHD (March 2000) set out a ten year framework for action to prevent disease, tackle inequalities, save more lives, and improve the quality of life for people with heart disease. An estimated 33,000 lives were saved in 2007 compared to 1996.
5. Inequalities in the death rate from heart disease, stroke and related diseases among the under 75s have been narrowing for the past eight years. The gap between the England average and the fifth of areas with the worst health deprivation scores has reduced by 32% since 1995-7.
6. Thrombolysis is a treatment for unblocking arteries with clot busting drugs.
7. Primary angioplasty, also known as primary percutaneous coronary intervention or PPCI, involves inserting, then inflating, a small balloon in the blocked coronary artery, leaving a rigid support, or 'stent', which restores blood flow. This procedure is carried out in a cardiac catheter laboratory.
8. There are different models of delivering primary angioplasty, for example, some patients are assessed first in the nearest hospital's A&E then transferred to the catheter lab in a primary angioplasty centre. Some are assessed by ambulance crew and taken to a primary angioplasty centre where they arrive in A&E before transferring to the catheter lab. The model which achieves the fastest times is assessment by ambulance crew and transfer directly to a catheter lab in a primary angioplasty centre, bypassing local hospitals and A&E.
9. 110,000 people every year in England have a heart attack.
10. The NIAP report's conclusions draw from findings involving over two thousand patients collected over three years from seven pilots (ten sites) in different service models and geographical locations in England:
Pilots Hospital base
1. Royal Devon & Exeter NHS Foundation Royal Devon & Exeter
Trust Hospital (Wonford)
2. South Tees Hospital NHS Trust James Cook University
Hospital (Middlesbrough)
3. West Yorkshire (Leeds Teaching Leeds General Infirmary
Hospitals NHS Trust)
4. Greater Manchester (Central Manchester Royal Infirmary
Manchester & Manchester Children's Wythenshawe Hospital
Hospital University NHS Trust) and
University Hospital of South Manchester NHS Foundation Trust
5. North East London (Barts & The London Network Heart Attack Centre
NHS Trust) at the London Chest
Hospital
6. South East London King's College Hospital NHS
Foundation Trust
7. North West London (Imperial College) St Mary's
Healthcare NHS Trustand Royal Brompton & HospitalHammersmith
Harefield NHS Trust Hospital Harefield Hospital
