Heart attack severity 'misjudged'

Doctors could be misjudging the severity of heart attacks on patients discharged from care, an international study has found.

The research, led by the University of Edinburgh, raised concerns that some patients could die unless follow-up treatment was improved.

Professor Keith Fox, of the university's cardiology unit, said: "Two-thirds of adverse events after a heart attack - which may be a further heart attack, stroke or major bleed - happen after a patient has been discharged from hospital.

"Our findings are of concern because we believe that the risk for patients whose heart attack was originally considered not as severe may be being misjudged."

The study took in data from the Global Registry of Coronary Events, including 46,000 heart attack patients from 115 hospitals in 14 countries. The likelihood of patients suffering another attack was compared with their original condition.

The research found that patients with full heart attacks were more likely to have another or die within the first 15 days. But the risk for those whose attack was not deemed as severe overtook that group within 26 days, suggesting a need for greater post-hospital care.

Prof Fox said: "As a result there may be some patients who should be, but are not, receiving treatments such as the placing of stents to open up the artery, drug treatments and lifestyle changes which could prevent a further heart attack from occurring.

"This does not mean to say that all patients who have had a heart attack will need surgical intervention, but that doctors should carry out a simple recommended risk assessment that unfortunately is not being routinely used, but which takes in a variety of factors to help work out the best treatment."

The global register's risk assessment looked at factors including age, heart rate, blood pressure, kidney function, heart failure and the type of heart attack.

It has been recommended in guidelines by the European Society of Cardiology, American College of Cardiology and American Heart Association, the university said.

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