The benefits of reperfusion therapy

Sep 01, 2009

The wider use of reperfusion therapy in patients with heart attack (AMI) can save millions of lives in Europe. Effective reperfusion therapy in an AMI patient can cut the individual risk of dying by half. AMI is caused by a sudden blockage of a coronary artery, one of the vessels supplying the heart muscle with oxygen and nutrients. Effective reperfusion therapy provides a timely and sustainable reopening of the blockage.

The WHO MONICA project showed that in European centres in the mid-1990s, in-hospital mortality of AMI patients was 13%; this was a time when only about 40% of the patients had reperfusion therapy. Today, specialist centres can provide effective reperfusion therapy to more than 90% of their AMI patients. In such centres, in-hospital mortality rate is now as low as around 5%.

The first development in reperfusion therapy was the application of fibrinolytic agents to dissolve the blood clots causing the vessel blockage. Analysis of data from earlier studies reveals that, on average, fibrinolytic agents can reduce infarct-related mortality rate by 18% compared with no reperfusion therapy. Fibrinolytic therapy is universally available and is still the mainstay of reperfusion therapy where healthcare resources are limited.

More modern catheter-based reperfusion strategies, however, are more effective. Compared with what can be achieved by clot-buster drugs, catheter-based therapy reduces infarct-related mortality by a further 37%. Using this approach, the is re-opened mechanically with a balloon catheter and vessel patency is usually stabilised by placement of a stent. Potent adjunct antithrombotic drug therapy prevents recurrent . The larger survival benefit from catheter-based reperfusion therapy as compared with fibrinolytic therapy can be attributed to a higher success rate in reopening blocked vessels (90% versus 40-60%) and to better sustainability.

If no reperfusion therapy is initiated and the infarct-related coronary artery continues to be blocked, the supplied by this vessel is destined to die. Loss of functional heart muscle can cause death by pump failure or break-down of normal heart rhythm. Moreover, it is a major cause of long-term illness due to heart failure. Effective reperfusion therapy can prevent the death of heart muscle cells and salvages a large proportion of the heart muscle at risk. In this way, reperfusion therapy effectively prevents chronic illness. The percentage of heart-muscle salvage varies to a large extent on reperfusion modality, timing of reperfusion and patient characteristics.

Catheter-based reperfusion usually salvages around 60% of the heart muscle at risk. For the individual patient this often means a normal life, despite having suffered a .

Source: European Society of Cardiology (news : web)

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

add to favorites email to friend print save as pdf

Related Stories

Novel compound may lessen heart attack damage

Feb 07, 2008

A novel drug designed to lessen muscle damage from a heart attack has passed initial safety tests at the Duke Clinical Research Institute. Results of the study, available online and to be published in the February 19 issue ...

New strategies for reperfusion therapy

Aug 31, 2009

PCI is the preferred strategy in acute myocardial infarction when performed by an experienced team as soon as possible after first medical contact.Time is essential: for P-PCI there is an 8 percent excess annual mortality ...

Recommended for you

What are the chances that your dad isn't your dad?

Apr 16, 2014

How confident are you that the man you call dad is really your biological father? If you believe some of the most commonly-quoted figures, you could be forgiven for not being very confident at all. But how ...

New technology that is revealing the science of chewing

Apr 15, 2014

CSIRO's 3D mastication modelling, demonstrated for the first time in Melbourne today, is starting to provide researchers with new understanding of how to reduce salt, sugar and fat in food products, as well ...

After skin cancer, removable model replaces real ear

Apr 11, 2014

(HealthDay)—During his 10-year struggle with basal cell carcinoma, Henry Fiorentini emerged minus his right ear, and minus the hearing that goes with it. The good news: Today, the 56-year-old IT programmer ...

User comments : 0

More news stories

Suddenly health insurance is not for sale

(HealthDay)— Darlene Tucker, an independent insurance broker in Scotts Hill, Tenn., says health insurers in her area aren't selling policies year-round anymore.