Fewer than half of Irish heart attack patients seek help within an hour, audit finds

The National Office of Clinical Audit said 45% of patients sought help within an hour in 2024, a decrease from 49% the year before.

Fewer than half of patients called for help within an hour of feeling the first symptoms of a major heart attack, a new audit has found.

The National Office of Clinical Audit said 45% of patients sought help within an hour in 2024, a decrease from 49% the year before.

Furthermore, it found smoking remains a major risk factor for suffering a heart attack, and causes one at much younger ages, with 36% of those presenting with a heart attack being current smokers and smokers experiencing a heart attack on average 11 years earlier than non-smokers.

“This year’s report highlights the need for a renewed focus on public awareness, system-level process improvement and targeted risk factor management to reduce the incidence and improve the treatment of [major heart attack] in Ireland,” Professor Ronan Margey, national clinical lead for the Irish Heart Attack Audit, said.

“The system is most effective when every step, from recognising symptoms to calling for help, diagnosis, transfer and treatment, happens without delay.” 

This latest audit report offers data on 1,615 patients who had a major heart attack, known as an ST elevation myocardial infarction.

It delves into the processes a patient enters once they seek help, including treatment with primary percutaneous coronary intervention (PCI), the internationally preferred therapy for a major heart attack.

The audit found once patients reach a centre offering PCI, treatment outcomes are in line with international standards.

However, its data suggests primary PCI was only delivered to 77% of eligible patients. This has been on the decline from 86% in 2017.

Only three in five (61%), meanwhile, received primary PCI within the recommended two hours after a heart attack is diagnosed.

For patients who first presented at a non-PCI hospital, only 3% achieved the target of 30 minutes from a door-in, door-out transfer to a centre that did offer that treatment.

Just over half (55%) of those arriving by ambulance to a PCI centre achieved the 30-minute “door-to-balloon" — first deployment of the necessary device — target.

On foot of the results, the National Office of Clinical Audit made four recommendations on a national level.

This included optimising the use and timelines of primary PCI and supporting hospitals to review local processes that can help with early diagnosis and faster transfer times, as well as shortening the door-to-balloon times.

As well as the clinical aspects, the report also delved into the importance of patient and public engagement in shaping improvement in services.

Paula Connor, a cardiac patient and member of the audit's governance committee, spoke of how symptoms can present differently, particularly for women.

“I was only 44 when I had my heart attack, and I didn’t realise what was happening,” she said.

“I just felt faint and had pressure in my arms. I was lucky to get help quickly and receive life-saving treatment. My message is simple, don’t ignore unusual symptoms and call 112 or 999 straightaway. Acting fast can save your life.”