Waterford heart attack patients have 'almost zero chance' of timely lifesaving treatment
Waterford cardiologist Dr Patrick Owens told the 'Irish Examiner' that time is of the essence when someone is suffering a heart attack.
People who have a heart attack outside office hours in Waterford have an almost “zero” chance of accessing lifesaving treatment within an acceptable timeframe as they have to be transferred to Cork.
That is according to Paddy Owens, a cardiology consultant at University Hospital Waterford (UHW), who was speaking after the latest national audit found that treatment for major heart attacks should be delivered within 120 minutes of the first medical contact for the patient.
The Irish Heart Attack Audit National Report analysed 5,629 patients across 2017-2020. It found that patients who received a “timely” primary percutaneous coronary intervention (PPCI) had a 2.8% in-hospital mortality rate, “compared to 5.2% in patients who are treated beyond the 120-minute window”.
The emergency PPCI treatment involves inserting a wire into the blocked artery and is delivered at 10 specialist centres across Ireland, including Cork, Limerick, Waterford, and Dublin.
It is considered the gold standard for those suffering major heart attacks.
Dr Owens told the the most important thing for someone suffering a heart attack is to access this treatment as quickly as possible, otherwise there is a risk of serious long-term health damage.
However, the PPCI lab in Waterford only operates from Monday to Friday, 9am to 5pm. Campaigners in Waterford and the wider region have lobbied for a number of years for a 24/7 cath lab, due to the lack of cover outside those hours.
A national review of cardiac services was commissioned on the back of the campaign and is to be published in the coming weeks.
Dr Owens, who is involved in the campaign for a 24-hour cath lab service, said a “headline message” everyone should take away from the audit is that the quicker you receive first medical contact the more likely you are to survive a heart attack.
One cardiac patient, Ciarán Murphy, required a transfer to Cork after suffering a heart attack on a Sunday in late 2019. He was brought via helicopter for PPCI. He told the his doctor said his heart has lost 25% usage.
“It’s puzzling me after all this time that they’re actually reviewing this,” he said of the national review, which was originally ordered in 2017. “They’re just dragging their heels as far as I can see.”
The cath lab is set to move to an 8am-8pm footing following a lengthy recruitment campaign, but Mr Murphy said this is merely “dribs and drabs” rather than the full service campaigners have sought.
Dr Owens said heart attack patients are “still much better off, even if it’s a matter of minutes” in the difference for emergency treatment, as there are different views on whether 120 minutes or 90 minutes are acceptable time frames for a patient to receive intervention.
“At either 90 minutes or 120 minutes, even in that two-hour interval, you do much better if you get to the hospital in the shortest time frame possible,” he said. “So, no matter which way you slice it, you’re still much more likely to get to Waterford if it’s delivering primary PCI if you’re in the southeast than you are if you’re travelling to Dublin or Cork.”
He warned that this week’s audit does not contain information on the “direct transfer time”, where an ambulance may bring a patient directly to Dublin or Cork instead of a local hospital.
The transfer time “ultimately forms the core of our argument” Dr Owens added.
“As things stand at present there is no mechanism for getting patients to primary PCI centres within acceptable time limits.”
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