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News and Featured Stories from St. Vincent's Medical Center
Published: 02/07/2007

St. Vincent's Pioneered New Angioplasty Standards More Than 10 Years Ago

St Vincent's Medical Center - Bridgeport CTBridgeport, CT, February 7, 2007 - When the American Heart Association released guidelines for treating heart attack victims last November, it was a special moment for cardiologists at St. Vincent's who introduced emergency angioplasty to the area back in 1995 and saw an immediate decrease in mortality from heart attacks.

The new report, issued by the D2B (Door to Balloon) Alliance and sponsored by the American Heart Association, has urged hospitals to adopt successful response strategies that have saved lives across the country.

D2B is the time from when a patient enters hospital doors to the time blood flow is restored to the heart by opening the blockage with angioplasty.

Researchers found that the timeliness of heart attack care in hospitals varies across the country and that the faster patients are treated, the better their likelihood of survival. D2B times in some hospitals can take 120 minutes or more.

Heart attack patients should be treated within 90 minutes of arriving at the hospital or the risk of dying increases dramatically. But studies show that 2/3 of heart attack patients in hospitals across the country end up waiting longer. At St. Vincent's, the time for emergency angioplasties is between 60-90 minutes, well below the national average.

Jose Missri, MD, Chairman, Department of Cardiovascular Medicine at St. Vincent's Medical Center, said the new national campaign hopes to spur other hospitals to use strategies like those developed by St. Vincent's Medical Center and other leading hospitals more than 12 years ago.

The goal is to get patients to a hospital quickly and then have a smooth process to assemble a team and get the balloon in the artery—a process known at Emergency Angioplasty or Primary Angioplasty for Myocardial Infarction.

"St. Vincent's was able to arrive at this achievement over a decade ago because of excellent cardiologists, high volume, participation in drug trails, and a history of innovation," said Dr. Missri. Edward Kosinski, MD, served as Chairman of Cardiology at the time and provided the leadership to introduce the new program.

"Above all this was an institutional achievement, a unique commitment on the part of St. Vincent's physicians and staff to serve our patients," says Dr. Kosinski, who continues to serve as a St. Vincent's cardiologist.

"The national recognition is a reflection of our history of innovation at St. Vincent's. With one of the first angioplasty and open heart programs in the state, our cardiology team continues to provide timely, high quality care that saves lives."

Dr. Missri said that when St. Vincent's introduced emergency angioplasty in 1995, it was the first in Connecticut and one of only 40 in the country (one percent of nation's hospital) to substitute angioplasty for the clot busting thrombolytics that were widely in use at the time.

Before the use of clot busters, people faced a much higher risk of death from heart attacks. The clot busters themselves represented a revolutionary breakthrough and reduced mortality by up to 50%.

However, the use of thrombolytics, which dissolved the clots, was quickly followed by the understanding that angioplasty (inserting a tiny balloon into the artery and opening it at the point of blockage) could work even quicker during a time in which every second counts.

Dr. Kosinski said St. Vincent's cardiologists began using angioplasty as the first line of defense against heart attacks in 1994. Early results were so promising that St. Vincent's decided to make a total commitment. Officially known as PAMI (primary angioplasty for myocardial infarction), the hospital announced that it would use this protocol 24 hours a day, seven days a week.

Results of the first year confirmed St. Vincent's commitment. The Medical Center saw a 68% drop in mortality echoing national figures. Today, St. Vincent's performs about 1300 angioplasties, with about 10% being emergency angioplasties.

"Angioplasty worked faster and created a superior opening," said Dr. Kosisnki. "It also reduced the length of stay and cost of thrombolytic drugs."

For information on the St. Vincent's Regional Heart & Vascular Center or referral to a cardiologist, call 1-877-255-SVHS (7847).

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