The Hindu : Kerala / Thiruvananthapuram News : Indians have more severe heart attacks than Westerners, says Lancet study

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Kerala - Thiruvananthapuram

Indians have more severe heart attacks than Westerners, says Lancet study

Staff Reporter

Thiruvananthapuram: Acute coronary syndrome patients in India tend to be younger and from low socio-economic groups and have a higher rate of the severe type of heart attack (STEMI – ST segment elevation myocardial infarction) than do patients in developed countries, an Indo-Canadian study, the results of which have been published in The Lancet in April 2008, says.

The prospective registry study was done in 89 centres in 50 cities in India and studied over 20,000 patients. In Kerala, the places from where patients were enrolled for the study included Alappuzha, Kochi, Kollam, Kottayam, Kozhikode, Palakkad and Thrissur. The data from India was compared with data from similar studies undertaken in the developed countries.

The study pointed out that heart attack victims in India received medical attention late and proven medical therapies were less often administered to them.

It recommended that strategies to reduce delays in access to hospitals and improvement in affordability of urgent care could reduce mortality and morbidity from acute coronary syndrome to a great extent in India.

So far, there have only been a few hospital-based studies on patients with acute coronary syndrome. This study, coordinated by St. John’s Research Institute in Bangalore and the Population Health Research Institute, McMaster University, Canada, is believed to be the first of such a magnitude from a developing nation.

The study concentrated on patients who were admitted to hospitals with three types of coronary artery disease that are associated with the sudden rupture of plaque inside the coronary artery: unstable angina, non-STEMI (less severe heart attack) and STEMI (severe type of heart attack).

Results

The researchers reported that 60 per cent of the Indian patients had STEMI, severe form of heart attack, while in reports from developed countries, including European Heart Surveys, fewer than 40 per cent had this kind of severe heart problem. Patients from different socio-economic strata had different key investigations and treatments and smaller proportions of poor patients received key treatments than the rich.

The researchers recorded major differences in the manner in which treatments were administered to acute coronary syndrome patients in India when compared to the registries in developed countries. In India, thrombolytic (clot dissolving) treatments for heart attack victims were higher than interventional procedures (angioplasty) when compared to the West.

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