Reperfusion therapy after heart attack has lasting benefits

Early restoration of blood flow to the heart after a Heart attack saves lives in the short term and a new study shows that the early survival benefits associated with so-called reperfusion therapy last for at least 20 years and probably for the rest of a person's lifetime.

"All efforts should be made to identify patients with evolving (Heart attack), and to provide rapid, effective reperfusion therapy without delay," study investigators write in the Journal of the American College of Cardiology.

Reperfusion therapy is treatment to restore blood flow to the heart, usually consisting of clot-busting drugs or artery-clearing Angioplasty - a procedure in which a balloon-tipped catheter is used to clear fatty plaques from coronary arteries.

As part of a clinical trial conducted in the 1980s, 533 Heart attack sufferers were randomly assigned to immediate reperfusion therapy with the clot-buster streptokinase with or without Angioplasty , or to "conventional" treatment (controls).

According to Dr. Ron T. van Domburg of Erasmus Medical Center, Rotterdam and colleagues, 20-year survival rates were much higher in the reperfusion group compared with the control group (37 percent versus 27 percent).

Among the 80 percent with successful reperfusion, the 20-year rate was 45 percent. For comparison, the expected survival rate of an age- and gender-matched reference population would be 56 percent at 20 years.

Overall, patients in the reperfusion group lived about 3 years longer than those in the control group.

"This is the first study demonstrating sustained (20-year) improved survival after reperfusion therapy," the authors note in their report.

SOURCE: Journal of the American College of Cardiology, July 5, 2005.