Heart attack patients with long-term health conditions are significantly less likely to receive optimal care, compared to those with no long-term condition. This disparity in care is associated with a higher risk of death, according to a study that we part-funded looking at the frequency of missed opportunities to treat people after a heart attack.
A BHF-funded team of researchers from the University of Leeds used data from the Myocardial Ischaemia National Audit Project (MINAP) to analyse 693,388 cases of heart attack, in 247 hospitals in England between 1st January 2003 and 30th June 2013.
The researchers looked at treatments that guidelines recommend be considered for patients who had a heart attack. They assessed how often these treatments were given and compared this with whether guidelines at that time suggested that they were appropriate.
86 per cent of patients did not receive optimal care
The team found that of the 40 per cent of patients with heart attack also had a long-term health condition, such as diabetes, stroke, heart failure and renal failure, 86 per cent did not receive optimal care and these patients had a 250 per cent increased risk of dying compared with patients who did not have a long-term condition.
Heart failure patients worst affected
The researchers also found that patients with heart attack and heart failure or renal failure were the least likely to receive optimal care. Patients with heart failure received 7.3% fewer treatments than heart attack patients with no long-term conditions, whilst patients with renal failure received 6.1% fewer treatments.
These patients had the highest risk of death, and for patients with heart failure and a heart attack, the researchers found that despite optimal heart attack care the risk of death was similar to patients who did not receive all heart attack care opportunities.
All patients should receive the best possible treatments
Our medical director, Professor Sir Nilesh Samani, said:
“It’s important that all patients receive the best possible treatments, regardless of any other conditions they might have. But it’s true that having another long-term condition can complicate things.
“Choosing the best treatment has to factor in the other medicines that the patient is taking, as well as the potential side-effects. This sometimes means a person doesn’t necessarily get the most effective treatments, but it still could be the best choice under the circumstances.
“This study shows that patients with long-term conditions could see substantial benefits if extra effort is put into deciding the best possible treatments. It also highlights the need for research to develop further treatment options for doctors and more effective medicines for these patients.”