A Sea Change in Treating Heart Attacks

Gina Kolata in The New York Times:

FirstFrom 2003 to 2013, the death rate from coronary heart disease fell about 38 percent, according to the American Heart Association citing data from the Centers for Disease Control and Prevention. The National Heart, Lung and Blood Institute, the primary federal agency that funds heart research, says this decline has been spurred by better control of cholesterol and blood pressure, reduced smoking rates, improved medical treatments — and faster care of people in the throes of a heart attack. “It may not be long before cardiovascular disease is no longer the leading cause of death” in the United States, said Dr. Michael Lauer, the director of the Division of Cardiovascular Sciences at the National Heart, Lung and Blood Institute. And care has improved not just in elite medical centers, but in local hospitals like Our Lady of Lourdes, here in a city littered with abandoned buildings and boarded-up homes that is among the poorest in America, according to the Census Bureau. Disparities that used to exist, with African-Americans, Hispanics and older people facing the slowest treatment times, have disappeared, Dr. Harlan Krumholz, a cardiologist at Yale, and his colleagues said in a paper in Archives of Internal Medicine.

The reinvention of protocols to hasten treatment is part of a broad rethinking of how to tackle coronary heart disease, which accounts for one of every seven deaths in the United States or 375,000 a year. Just this month, powerful drugs from the first new class of medicines to lower bad cholesterol levels in a generation neared approval by the Food and Drug Administration, raising hopes that they will further reduce the death rate from heart disease. At the same time, new, less invasive methods for replacing aged heart valves are raising hopes that ailing patients will be able to live longer. And researchers are immersed in resolving issues that remain unsettled: the utility of stents to treat the heart pain known as angina and the ideal level for blood pressure.

More here.