Study: Most first-time heart attacks could be avoided

Most first-time heart attack patients are not taking well-known medications that could have prevented their heart attacks, a study by a group of Twin Cities cardiologists found.

The study, presented Monday during an American Heart Association meeting in Chicago, may mark the first time research has looked at the treatment patients received prior to their heart attack.

Its findings are discouraging because they suggest that many high-risk patients are either ignoring medical advice or are not being identified by doctors early enough.

The good news on heart attack treatment in Minnesota is that the state experienced a remarkable drop in hospital admissions for heart attacks since 2007. Last year, fewer than 78,000 people were treated for a heart attack, down 15 percent from three years ago, when there were 91,000 admissions.

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Dr. Kevin Graham, President of the Minneapolis Heart Institute, believes the trend is due in part to public smoking bans and to the widespread adoption of some basic drug therapies.

"We know that people who are on an aspirin, one aspirin a day will decrease people at risk, their incidence of heart attack 25 percent," Graham said. "It's the most cost-effective thing we can do."

But the Institutes' own data suggest that too few people are getting that message.

When Graham's team at Abbott Northwestern Hospital examined the medical records of 815 first-time heart attack victims, they found that very few were taking any preventative therapy.

"Less than 1 in 10 patients who presented with acute heart attack was on the simplest, cheapest medicine that's known to prevent heart attacks which is aspirin," he said. "So what we found is that if you have a high risk group of people such as this who are not taking preventive medicines, bad things happen."

Identifying these high-risk patients is not difficult for physicians. The risk factors are well-known. Smoking, having diabetes, high blood pressure and high cholesterol all raise the risk of heart disease significantly.

But many first-time heart attack patients may have quietly developed their disease over many years. Graham said if they haven't seen a doctor during that time period, they probably haven't been warned about their risks.

"A 55-year-old who smokes, has high cholesterol [and] is 30 pounds overweight is surprised that he or she will present with a heart attack," Graham said. "We're not surprised at all. But for them it's a surprise."

The study is thought to be the first to document what was done to protect patients before they suffered a heart attack. Cardiologist Jay Cohn said most hospitals could pull together similar data if they wanted to.

"Every hospital is seeing heart attacks coming in and yet nobody has done the analysis to determine how well they're being treated," Cohn said. "So, it points out that, I think our emphasis has been managing heart attacks in the most effective way, and much less interest in preventing heart attacks."

Now that doctors have better information about first-time heart attack patients, they can put out the word to their peers and patients that early screening is critical, said Cohn, director of the Rasmussen Center for Cardiovascular Disease Prevention at the University of Minnesota.

"This could become a major factor in reducing health care costs," he said. "If we knew who was at risk and could treat those people at risk to protect them, the potential for that is astounding."

This year alone, serious heart conditions will cost the nation more than $300 billion in health care services, medication and lost productivity, according to the federal government.

Preventing heart attacks is a crucial element of the health care overhaul passed by Congress. Heart failure kills more people in the United States than any other disease.