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NEW HAVEN — Lives can be saved by treating heart attack patients who go into shock less aggressively, according to a Yale School of Medicine study.
Doctors at Yale and Beth Israel Deaconess Medical Center compared the outcomes of two treatments for cardiac patients with low blood pressure. About 30 percent of them have stents placed in any blood vessel that is restricting blood flow to the heart, according to a release. Others have stents placed only in the blood vessel that caused the heart attack, known as “culprit-only” strategy.
While a 2017 study had found that the more aggressive treatment led to a higher death rate, this was the first study to compare the two therapies, according to the release.
The study, which looked at 64,301 heart attack patients who had gone into shock from 2009 to 2018, found a wide variation in treatment. According to Dr. Rohan Khera, an assistant professor of cardiovascular medicine at Yale and first author of the study, “those hospitals using multi-vessel treatments more frequently had worse patient outcomes.”
More than one-third of all heart attack patients who go into shock die in the hospital and about half die within a year, the release said. Heart attack patients who do not go into shock have a mortality rate of less than 5 percent, the release said.
“Our work emphasizes the need for optimization of care practices for a group of patients who experience really bad outcomes,” Khera said. “In this case, less is more.”
The new study appears in the journal JAMA Internal Medicine.