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: What to do with kidneys from older deceased donors?

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

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.