Five Tips to Improve Survival Following a Heart Attack

Researchers from The University of Leeds have identified certain factors that could improve survival of heart attack patients. A heart attack can be fatal if the patient does not receive immediate medical attention. A heart attack occurs when a portion of the heart does not receive enough blood and deprives heart muscle of oxygen supply. In most instances, a heart attack is caused due to coronary heart disease.

Symptoms of a heart attack

It is important to understand the symptoms that could occur during a heart attack to be able to identify an attack, these include –

• Chest pain
• Pain in the hand, back, stomach which can range from being a discomfort to being severe.
• Shortness of breath
• Feeling light headed

Golden Hour

The most important aspect in surviving a heart attack is to get the patient to reach a hospital or to receive medical care within the golden hour.

The golden hour is the critical hour from the start of the heart attack and the patient should reach the hospital within this time. Most fatalities occur when the patient does not receive medical care during this period.

A study published by Dr.Hall and colleagues lists the following tips to increase chances for survival after a heart attack. The study was conducted following a decline in the number of fatalities following a heart attack globally and the authors wanted to identify factors that contributed to this decline among non-ST elevation Myocardial Infarction (NSTEMI) type of heart attacks.

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Five Tips to Improve Survival following a Heart Attack

Tip 1: Invasive Coronary Strategy

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389,057 patients with NSTEMI were studied during the period from 2003 to 2013, out of which there were 113,586 deaths. Parameters that were studied to understand the risk were

• Systolic blood pressure
• Heart rate
• Elevated enzyme levels

Further analysis to understand the lowered mortality rates and risk after a heart attack, showed that invasive coronary strategy lowered mortality rates by 46%. The strategies included percutaneous coronary intervention, coronary angiography and coronary artery bypass graft surgery

Based on these parameters, the risk level was found to be lowered. The mortality also decreased from 10.8% to 7.8% at 180 days.

Tip 2: The use of Aspirin & P2Y12 inhibitor

Aspirin is a blood thinner and is used to restrict the formation of clots which lead to a heart attack. Aspirin is widely used among heart patients and is found to have other associated benefits. Taking aspirin during such an episode helps lowering the fatality.

The use of P2Y12 inhibitor too has been found to be effective as anti-thrombotic therapy. Dominic Angiolillo in their study titled “Update on novel p2y12 inhibitors: focus on prasugrel, ticagrelor, cangrelor and elinogrel”. These drugs inhibit the development of platelets and can lower recurrent heart attacks.

Tip 3: Beta Blockers

Beta blockers work by lowering the heart rate, which lowers the requirement of oxygen by the heart with a reduction in the frequency of heart attacks.

Tip 4 : Angiotenesin Converting Enzyme(ACE):

ACE increases the size of the blood vessels, making them wide. This lowers blood pressure and the risk of another heart attack.

It has been found that the intake of salt lowers the activity of the enzyme and a high salt diet should be avoided.

Tip 5: Statins

Statins are found to lower the level of LDL cholesterol which is considered to be the bad cholesterol. The build up of cholesterol in the body can lead to blockage of the arteries which increases a heart attack risk. Regular intake of statins will help control the risk for a heart attack as a long term strategy.

Though many of these drugs have been in use among heart patients, this study found a significant association between the above factors and survival after a heart attack, thereby reinstating the importance of these drugs in cardiac therapy.

What is non-ST elevation Myocardial Infarction (NSTEMI) type of heart attacks?

Non-ST Segment Elevation Myocardial Infarction (NSTEMI) is a medical emergency and is one of the 3 types of heart attacks or Acute Coronary Syndrome (ACS).

The three types of Acute Coronary Syndrome (ACS) are as follows -

• STEMI (ST Segment Elevation Myocardial Infarction) - a “full” heart attack
• Non-ST Segment Elevation Myocardial Infarction (NSTEMI)
• & Unstable angina

In all the three types a plaque inside the arterial wall of coronary artery ruptures and causes partial or complete blockage to the flow of the blood to the cardiac muscles.

If the blockage is complete it results in STEMI and the ST segments of the ECG ( or electrocardiogram) become raised or elevated on the tracing and the cardiac enzymes too rise. This will result in death of heart muscle.

However in both unstable angina and NSTEMI, the blockage partial or not complete and the chances of these becoming a "full" heart attack is very high unless an intervention is undertaken. Also both are similar except in other ways too except that in NSTEMI the cardiac enzyme blood tests are abnormal. This indicates that at least some actual cell damage is occurring to heart muscle cells.

Disclaimer: MedIndia does not endorse any of the above factors and individuals need to consult a certified medical professional before undertaking any medication or procedure.

References:

1. Aspirin and Heart Disease - (http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeart Attack/Aspirin-and-Heart-Disease_UCM_321714_Article.jsp#.V8UrclR97IU)
2. Heart Attack - Symptoms - (https://www.bhf.org.uk/heart-health/conditions/heart-attack)
3. Heart and Stroke Statistics - (http://www.heart.org/HEARTORG/General/Heart-and-Stroke-Association-Statistics_UCM_319064_SubHomePage.jsp)
4. Drug Cabinet: Beta blockers - (https://www.bhf.org.uk/heart-matters-magazine/medical/drug-cabinet/beta-blockers)

Source-Medindia