The mortality rate from heart attacks has dropped more than 50 percent in the last decade, but about half of those who suffer from cardiac arrest are actually at an increased risk of death because they wait too long to call for help, according a survey released Wednesday by the Israel Heart Society.
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The heart attack victims with the highest risk of death are the ones who experience cardiac arrest at night. According to the Acute Coronary Syndrome Israeli Survey, Israelis who suffer heart attacks at home during the day or evening wait an average of about 90 minutes from the time they first experience severe chest pains – the first obvious sign of a heart attack – until the time they call for help. That stretches to 120 minutes when the attack occurs between midnight and 8 A.M.
By contrast, when someone exhibits signs of a heart attack in a public place or at work, help is usually summoned within 36 minutes. “In public places there are work colleagues or other people at the site who will call the mobile intensive care unit and hasten the arrival at the hospital," explains Professor Shlomi Matetzky of Sheba Medical Center, who coordinated the survey.
Even a few minutes can make a huge difference for victims of heart attacks. From the time help is called, it takes 42 minutes, on average, before the patient even gets to the hospital, and another 68 minutes before treatment is actually administered. Only 64 percent of heart attack victims are taken to the hospital by a mobile intensive care unit. Nine percent are taken in a regular ambulance, and the rest either travel there on their own or are brought by friends or relatives.
Over the past decade, the mortality rate among heart attack patients a week after the attack has gone down from 5.2 percent to 2.1 percent. The mortality rate after a month also dropped by half, from 8.5 percent to 4.2 percent.
The survey, which is conducted every three years, examined the records of 1,981 heart attack patients in April-May 2010. It includes data from all 26 cardiology departments in Israel’s general hospitals.
Researchers have discovered that gaps in mortality rates by region appear to have been eliminated, even though the gaps in available health care services persist. The previous survey, published in 2009, had found that more people died of heart attacks in the outlying areas than in the center of the country.
There remains, however, a significant difference in the rate of referrals for rehabilitation following a heart attack – a service that is included in Israelis' health-care basket. If you have a heart attack in the north, for example, you are 15 percent less likely to be referred for rehab than if you suffered the attack in the center.
The report also noted a significant increase in the number of heart attack patients treated by catheterization, from 58 percent in 2000 to 90 percent in 2010, with a simultaneous drop in the number of patients undergoing surgery, from 8.7 percent to 1.7 percent.
The cardiology society started collecting data this month for the next survey. It is being conducted for the first time in conjunction with the Magen David Adom rescue service and will examine the treatment heart attack victims receive in the field, before they are brought to the emergency room.