Postcode lottery claims heart attack victims

Patients are dying unnecessarily from heart attacks in rural areas because of a new postcode lottery in care standards, Health Direct has learnt.

Heart attack victims in London and other major cities are diverted past their nearest A&E; to special hospital units where they have an operation to stop the attack.

But in many rural areas patients are either given less-effective drugs in the ambulance or receive them at their local hospital.

Patients who receive the operation, known as primary angioplasty, are at least twice as likely to survive, suffer less damage to their heart, leave hospital on average two days sooner and have a better quality of life afterwards.

The operation involves inflating a balloon in the blocked artery to reopen the blood flow. Last year only a fifth of heart attack patients received the treatment.

Data has shown it is most effective when carried out within two hours of the onset of chest pain. If more centres were set up, all patients in rural areas could be picked up by air ambulance and be in the operating theatre within that time.

The mortality rate from heart attacks within the M25 has halved since the network of specialist units started providing round-the-clock primary angioplasty. The treatment is provided round-the-clock in London, the West Midlands and Greater Manchester.

Patients in East Anglia, Hereford, Worcestershire, Cheshire, Merseyside and Kent receive only clot-reducing drug treatment known as thrombolysis.

Thrombolysis has a 60-70 per cent success rate and the number of patients who go on to suffer a further clot is relatively high. With a primary angioplasty, the success rate is about 90 to 95 per cent.

Prof Martin Rothman, the development director of the London Chest Hospital, said: “It is a turf issue between doctors, and different ambulance services have trained their paramedics to use the thrombolysis drugs instead.

“Thrombolysis is a dark ages approach. If you give the drugs to the wrong patients, those who are not having heart attacks, it can be fatal, and that does not happen with primary angioplasty.

“Data clearly shows primary angioplasty is better. It is a postcode issue. There is no reason why primary angioplasty should not be rolled out across the country.”

Prof Peter Weissberg, the medical director of the British Heart Foundation, said Britain is moving towards a primary angioplasty service but it should not be attempted overnight as this would damage the “first class” thrombolysis service.


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