Heart attack care
Heart attack (acute myocardial infarction) care at Gill Heart & Vascular Institute
A heart attack or acute myocardial infarction (AMI) is a serious condition that leads to hospitalization and has the potential to result in death or long term ill-health. In America, it is estimated that 790,000 new AMIs occur every year. In other words, an American will suffer a heart attack every 43 seconds.
The Acute Myocardial Infarction Patient Care Team at the Gill Heart & Vascular Institute is focused on providing the best, timely and most appropriate treatment for every patient with AMI, based on the latest scientific evidence and guideline recommendations.
To monitor our performance and be able to compare our progress with other hospitals across the US, our team submits quarterly data to the Chest Pain-MI Registry™ (formerly known as ACTION Registry™) which is part of the American College of Cardiology (ACC) National Cardiovascular Database Registry (NCDR). This is a care-based quality improvement program that focuses exclusively on heart attack patients; it helps hospitals apply clinical guideline recommendations in their facilities and provides tools to measure and to improve patient care.
What follows are a few of our patient care results that we feel deserve special attention:
Overall defect-free care
This is a combined measure we assess for all patients with AMI. It represents the proportion of patients that receive “perfect care.”
Ideally, these performance measures should be met for every patient every time.
These include very rapid angioplasty and stenting to open the blocked artery, administration of aspirin on arrival, ensuring that proper medications are given during hospitalization and at discharge, assessing heart function, referring heart attack patients to cardiac rehabilitation programs and ensuring they get effective counseling to stop smoking.
The Gill Heart & Vascular Institute (GHVI) program performs in the top 10% in defect free care across all US participating Hospitals.
Time in minutes to primary angioplasty
A heart attack usually occurs when blood flow to the heart is suddenly cut off, most likely because a blood clot forms on top of a plaque buildup in the wall of the artery. When this happens, the heart muscle is starved of oxygen-rich blood. In just a short period of time, part of the heart can be damaged or die. That’s why immediate care is critical–it can spare your heart and save your life.
It is essential to open the occluded vessel with a balloon angioplasty as quickly as possible. Our median time for opening a blocked artery is 44 minutes. The Gill Heart & Vascular Institute Interventional Team performs in the top 10 percent for all US Participating Hospitals.
The Gill Heart & Vascular Institute performs in the top 10% of all hospitals in time to PCI. Since delays lead to heart muscle death, a lower time is better.
Appropriate medications at discharge
Aspirin is the first-line therapy for a heart attack and should be continued indefinitely after AMI.
100% of our patients receive aspirin at discharge.
Patients who had an AMI are at high risk for recurrent cardiac problems. That is why it is important that they get effective treatment to prevent their platelets from causing more blood clots. Typically, when those patients undergo emergent angioplasty procedures, they get a stent (which is similar to a small tube) implanted thereafter to keep the artery propped open for blood flow. In addition to aspirin, another class of drugs (ADP receptor antagonists) is needed for all heart attack patients. We at the GHVI received a perfect score for prescribing ADP receptor antagonists to all our heart attack patients.
Beta blockers are another class of medications that reduce the workload of the heart by reducing heart rate and blood pressure. They also reduce the risk of the heart going into dangerous and possibly fatal disturbances in rhythm, which is one of the deadly complications of heart attacks. That’s why beta blockers are indicated for all heart attack patients unless there is a contra-indication to their use. We are in the top 1% for prescribing beta-blockers at discharge.
Statins are medications used to lower cholesterol levels in the blood. A specific type of cholesterol “LDL” is known to be cause plaque buildup in the coronary arteries, which can result in heart attacks. It is very important for all heart attack patients to receive statins to lower their LDL cholesterol. We received a perfect score for prescribing statins to all our heart attack patients.
Adult tobacco cessation advice and cardiac rehab referral
Cigarette smoking is the leading preventable cause of death. Smoking significantly increases your overall chances of developing heart disease because it directly damages your heart and blood vessels. Patients who still use tobacco after a heart attack are particularly vulnerable to having another heart attack. It is crucial to stop any tobacco use after a heart attack. The GHVI team provides counseling about the importance of that step in reducing future risk. We also provide directions regarding medical and community resources that help smokers overcome this dangerous habit. We are a top performer in this measure too.
Cardiac rehabilitation (rehab) teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. In cardiac rehab, a team of health professionals provides education and support to help you recover after AMI and build new, healthy habits, such as eating right and getting more exercise. All MI patients receive referrals to cardiac rehab. Of those patients that go to rehab, 100% of our patients complete their rehab sessions.
* Data Source:
The American College of Cardiology’s Action Registry Version 2.4.2 2018 Q2 Outcome report. The Registry includes 954 participating hospitals.