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After Heart Attack, Risk
May Linger for Lifetime
Excerpt
By Alison McCook, Reuter's Health
NEW YORK (Reuters
Health) - A study of heart attack patients
from the 1950s, 1960s and 1970s suggests that 5% of heart attack
survivors who do not receive modern medications --such as aspirin--will
die each year after leaving the hospital.
The risk seems to persist indefinitely,
"probably for the rest of a person's life," Dr. Malcolm R. Law
of the University of London in the UK and colleagues report in
the November 25th issue of Archives of Internal Medicine.
The researchers found that if such
patients did suffer a second heart attack, 33% died before reaching
the hospital, 20% died in the hospital, another 20% died in the
first year after leaving the hospital and mortality was 10% per
year after that.
Law told Reuters Health he hopes
these figures will alert doctors to the importance of treatment
to help patients who have ever experienced a heart attack--also
known as a myocardial infarction (MI)--stay alive. "Ensure that
everyone who has had an MI, even years previously, takes preventive
treatment," he said.
Patients can also take steps to
stay healthy after a heart attack, Law added, by taking the preventive
treatments offered by their doctors, stopping smoking and asking
housemates to stop smoking as well.
Law and his colleagues base their
findings on an analysis of 23 previously published studies in
which researchers followed people after they experienced a heart
attack. Together, the studies included information on 14,211 patients
and 6,817 deaths. None of the studies followed patients past 1980,
when better treatments became available.
In an interview with Reuters Health,
Law explained that treatments that can help keep patients alive
after they experience heart attack include aspirin or other drugs
that prevent blood clots, and medications designed to reduce high
blood pressure, which include beta-blockers, ACE inhibitors or
calcium channel blockers. In addition, he said that doctors now
often give patients cholesterol-lowering statins, or even folic
acid, which recent research suggests may help ward off cardiovascular
disease. Although aspirin has been around for more than 100 years,
the first randomized trial showing that it could help heart attack
survival was published in 1979, according to the report.
Indeed, before 1980, Law's team
found that 10% of patients who survived a first heart attack died
within a year following the episode, and 5% of these patients
died during each subsequent year. After 15 years, 70% of all patients
who had experienced a heart attack had died from cardiovascular
disease, the authors report.
After a second heart attack, patients'
deaths jumped to 20% during the first year, and plateaued at 10%
for every subsequent year of their lives.
Law explained that a heart attack
indicates that some of the heart muscle no longer functions. As
such, he noted, some people lose so much heart muscle, they are
unable to survive even one year after their attack. A second heart
attack can damage their heart muscle even further, Law added.
"Death rates are higher after a
second MI because not many people have sufficient functioning
heart muscle left after two MIs," he said.
SOURCE: Archives of Internal Medicine
2002;162:2405-2410.
Reference
Source 89
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