Monday, June 30, 2008

Analysis Shows Heart Attacks Under-Treated Following Hospitalization

According to an analysis published Junes 23 in the Archives of Internal Medicine, one in five patients experience angina (chest pain) within the first year after a heart attack, at least once a week. The association was strongest in younger patients, those who have had coronary bypass surgery (CABG), smoke, experience depression and had symptoms at rest during hospitalization. The study was led by Dr. Thomas M. Maddox, from the Denver Veterans Affairs Medical Center, Colorado. Data was obtained from the Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recover (PREMIER) registry.

Co-author, Dr. John S Rumsfeld (Denver Veterans Affairs Medical Center) believes smoking and depression should be a major focus that physicians should target to help patients improve outcomes after experiencing a heart attack. He urges doctors to remain vigilant during the first year in order to provide continuous care to this sector of patients. “Right now our healthcare system is set up to provide care in small episodes: either you’re in the hospital or not, or in the clinic or not - and that’s not a patient- centered healthcare model", says Dr. Rumsfeld.

What happens at home, after a patient is discharged from the hospital and returned to the care of their primary physician, is a concern. Dr. Rumsfeld believes that care following a heart attack requires some quality improvements to “make a real difference to patients’ quality of life and how long they live.”

It’s normal to experience depression after a heart attack. Many patients have difficulty with smoking cessation. Past studies have shown that depression alone accelerates the risk of poor outcomes, including re-hospitalization, recurrent chest pain and greater physical limitations(1). Studies also show that younger women are more prone to depression after a heart attack.(2)

Patients and family members can take an active role by reporting symptoms of depression and ongoing chest pain. It’s important to understand that self-help includes compliance with medication and open communication with your family physician. The American Heart Association has valuable resources for patients and caregivers. You can visit their site for more help and information about a “heart healthy life”. Don’t leave it all up to your doctor – take an active role in your care and discuss treatment options for smoking cessation, treatment of depression and cardiac rehabilitation programs.