Heart patients may fare as well with drugs: study

Treating first-time Heart attack patients with aspirin and other drugs is less costly and can be just as beneficial as performing invasive procedures such as heart bypass surgery, researchers said on Tuesday.

Based on a seven-year study of nearly 160,000 Medicare patients, the report concluded that neither treatment style is allotted fairly and that treatment varies by region of the United States.

More than 280,000 patients covered by Medicare, the government health care program for older Americans, are admitted to hospitals each year after suffering a Heart attack and 18 percent die within 30 days, the study noted.

Treating patients with aspirin, blood pressure drugs and anti-clotting medications produced survival rates comparable to those of invasive procedures such as angioplasty or bypass surgery, if the care was managed carefully, said the study, which was published in the Journal of the American Medical Association.

The study found in general, younger and healthier patients were more likely to receive more intensive treatment than higher-risk older patients, although the latter would stand to benefit more.

"The sobering thing is that younger people get more treatment than they need and older people get less than they need," Dr. Eric Topol of the Cleveland Clinic told AMN Health when asked to comment on the study's findings.

In regions with abundant medical resources such as catheterization labs, patients had a six-percent better seven-year survival rate than regions with the fewest resources, the study said. But in areas of the country with better care, invasive procedures did not boost survival rates beyond those produced by intensive drug treatment, a style of care called medical management.

"While (heart attack) survival has improved compared with 30 years ago, invasive treatment and medical management are not optimal as practiced in the United States," wrote study author Therese Stukel of Dartmouth Medical School in Hanover, New Hampshire.

In her report, Stukel recommended delivery of comprehensive drug treatment to first-time heart attack patients be made a "national priority."

"The data in this article are disconcerting," Topol said. "Heart attack patients are better off in hospitals where they have several treatment alternatives...(but) there's been nothing done in this country to create regional centers - we're behind Denmark and the Czech Republic in this regard."

In an accompanying commentary in the journal, Saif Rathore of Yale University School of Medicine, in New Haven, Connecticut, disagreed, saying the study's findings indicate that counseling local hospitals on how to administer drugs correctly is needed, not channeling patients to regional centers.

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