Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, March 21, 1990 TAG: 9003212142
SECTION: NATIONAL/INTERNATIONAL PAGE: A2 EDITION: METRO
SOURCE: Associated Press
DATELINE: NEW ORLEANS LENGTH: Medium
New clot-dissolving medicines can literally stop a heart attack if given within a few hours after the start of chest pains. But many heart doctors believe this treatment has been too slow to catch on in the United States.
The reasons vary, but some advocates of aggressive treatment say their colleagues' fear of malpractice suits has played an important role.
"This has been one of the main impediments to the proliferation of treatment in the United States," said Dr. Robert Califf of Duke University.
Califf raised the issue at this week's meeting of the American College of Cardiology. Many other heart specialists said they agreed.
When all goes well, the new drugs, known as thrombolytic agents, clearly save lives. A heart attack usually occurs when a blood clot gets stuck in the arteries that feed the heart. Within a few hours, a section of the heart muscle dies.
But if given quickly, the drugs can dissolve blood clots, preventing most of the damage. In studies, the treatment typically has reduced the heart attack death rate from 12 percent to 6 percent.
But the treatment can trigger a major side effect: unwanted bleeding. If a blood vessel spews blood inside the brain, doctors are powerless to stop it. The result is often a crippling stroke. Such strokes occur in about one in 200 or 300 people who receive the clot-dissolving drugs.
Doctors routinely exclude people at high risk of bleeding from the treatment, including those with high blood pressure, the elderly and victims of prior strokes.
by CNB