Ops best for heart patients

An operation offers heart attack victims a better prognosis than drug treatment, researchers have found.

A review of studies carried out in the area found the procedure, angioplasty, is better in both the shorter and longer term than thrombolytic therapy which uses drugs to dissolve blood clots.

The aim of both treatments is to improve coronary artery blood flow to the heart and reduce the risk of further problems and deaths from heart problems.

Over 7,700 patients who had experienced a particular type of heart attack were covered by 23 studies carried out over the last three decades.

All had suffered a type called acute ST-segment elevation myocardial infarction.

In an angioplasty, a balloon is inserted into an artery which has become partially blocked and narrowed, restricting vital blood flow to the heart muscle.

In the UK, over 270,000 people have a heart attack every year - one every two minutes. Benefits

Researchers from the University of Texas Southwestern Medical Center, US, found angioplasty was better in the short term (four to six weeks) at reducing deaths (7% compared with 9% for medical therapy), another non-fatal heart attack (3% compared with 7%), stroke (1% compared with 2%), and any problem (8% compared with 14%) than the drug therapy.

The same differences in prognosis were seen when patients were followed up over longer periods of six to 18 months.

Lead researcher Ellen Keeley said: "Our findings indicate that primary angioplasty is better than thrombolytic therapy at reducing short-term major adverse cardiac events, including death in individuals with ST-segment elevation acute myocardial infarction.

"Furthermore, these favourable results are sustained during long-term follow-up."

Speed crucial

Belinda Linden, head of medical information at the British Heart Foundation said: "There has been mounting evidence to support the preferred option for angioplasty over thrombolysis for people suffering from a heart attack."

But she added: "This is a US study and we have to consider the resource implications such as facilities and manpower which would be needed for more widespread use of angioplasty in the UK.

"It is important not to discount the benefits of thrombolysis as a treatment option - it is quick, inexpensive and can reach a large number of patients.

"Speed of action - whatever the choice of treatment - remains a priority so that the patient has improved blood flow to minimise the damage to the heart muscle."

The research is published in The Lancet.