AHCPR-Funded Study Finds Thrombolysis Saves as Many Lives as Angioplasty and Costs Less

Press Release Date: October 23, 1996

A new study reports that the use of primary coronary angioplasty in the average community hospital does not reduce deaths more than thrombolytic therapy, and furthermore, it produces significantly higher costs over time. The finding, from a team of researchers supported by a grant from the federal Agency for Health Care Policy and Research (AHCPR), appears in an article in the October 24th issue of The New England Journal of Medicine (NEJM).

Heart attack is the leading killer of American men and women. Many heart attack victims are treated with either primary coronary angioplasty an invasive procedure to open occluded coronary arteries or thrombolysis rapid application of clot-busting drugs. Although a few small-scale clinical trials suggest that angioplasty is more beneficial, their findings have never been replicated in the average community hospital, which is where most Americans are taken when they have a heart attack.

After analyzing data on more than 3,000 heart attack patients treated at 19 Seattle hospitals between 1988 and 1994, and for up to three years after discharge, the research team found no significant differences in short- or long-term mortality between the two groups. They did find, however, that thrombolytic therapy led to fewer tests and other procedures than primary coronary angioplasty, and cost, on the average, $3,000 less per patient. According to the researchers, nationwide cost savings could be very significant, if applied to the nearly 200,000 patients eligible for thrombolysis each year.

The study, "A Comparison of Thrombolytic Therapy with Primary Coronary Angioplasty for Acute Myocardial Infarction," by Nathan R. Every, M.D., and others, is from a major, 5-year AHCPR-supported cardiac treatment research project now in its third year. The $4.8 million Cardiac Arrhythmia Patient Outcomes Research Team project is led by Mark A. Hlatky, M.D., of Stanford University.

Editor's Note: The NEJM article is embargoed until October 23, 1996, 5:00 p.m. EDT. For more information on this study or on AHCPR's other PORT projects, please call Howard Holland at (301) 427-1857, between 9 a.m. and 5 p.m., EDT.

For more information, contact AHCPR Public Affairs: Howard Holland, (301) 427-1857.