UCSF Medical Center leads nation in ER heart attack care

UCSF Medical Center ranks No. 1 nationwide for the speed with which heart attack patients are treated using balloon angioplasty, according to the National Cardiovascular Data Registry (NCDR). Cardiac balloon angioplasty and stenting are the procedures used to open narrowed or blocked blood vessels and must be performed quickly after a heart attack to minimize heart muscle loss.

Patients were treated by UCSF interventional cardiologists on average less than an hour—56 minutes for the first quarter of 2008 and 52 minutes for the second—after arriving in the Emergency Department, considerably faster than the 90-minute benchmark set by NCDR.

UCSF was first among more than 850 hospitals participating in the survey, which accounted for a 12-month period ending June 2008.  UCSF began reporting its treatment time to the NCDR in January 2007 and has led the nation since April 2007.

The NCDR, working in conjunction with the American College of Cardiology, compiles benchmarking data for cardiovascular patient care.  In 2007, the average time reported by hospitals for balloon angioplasty – beginning when the patient enters the emergency room – was 118 minutes. Currently, the average time among all hospitals reporting is 106 minutes.

“This outstanding performance reflects the hard work of so many people in the Emergency Department and Cardiac Catheterization Lab,” said Yerem Yeghiazarians, MD, interventional cardiologist and co-director of the UCSF Adult Cardiac Catheterization Laboratory. “Our focused team effort results in beneficial outcomes for our patients.”

The American College of Cardiology initiated a nationwide campaign to improve to 90 minutes or less “door-to-balloon” time, the name given for the time spent between a patient’s arrival at the hospital to the receipt of angioplasty surgery to unblock clogged arteries.  The risk to patients increases with every minute delayed for treatment.

“Heart attacks range in severity according to whether arteries are totally or partially blocked,” said Thomas Ports, MD, interventional cardiologist and co-director of the UCSF Adult Cardiac Catheterization Laboratory. “If arteries are fully blocked, mortality increases significantly every 30 minutes that a patient goes without treatment.”

For the procedure, a catheter is inserted into a leg or arm artery and fed into the blocked artery around the heart. A balloon, connected to the catheter, is expanded to open the artery. Cardiologists then place a wire mesh tube, called a stent, at the area of blockage to keep the artery open.

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