Australian heart attack survival among best in world – but could be better

Researchers have praised healthcare systems in Australia and New Zealand, after both nations recorded some of the world’s best long-term recovery rates for heart attack sufferers.

University of Queensland and Prince Charles Hospital cardiologist  Associate Professor Isuru Ranasinghe and UQ Faculty of Medicine’s Dr Linh Ngo contributed to a study which found 62.3 per cent of heart attack sufferers in these nations lived a further seven years or more.

“The survival rates we reported exceed those in the United States and England and are in the realm of Sweden, which had the best reported seven-year survival rate,” Dr Ranasinghe said.

“From the 239,402 admissions with acute myocardial infarction (AMI), we found the survival rate in Australian and New Zealand hospitals was 76.2 per cent after three years, 68.6 per cent after five years, and 62.3 per cent at seven years.

“In particular, the prognosis for patients aged under 65 was excellent, with survival rates after seven years exceeding 85 per cent.

“Improved, evidence-based care is likely to explain these high survival rates, with secondary preventative measures such as targeted medicines increasing substantially since the year 2000.

“In the years 1999 and 2016, the frequency of urgent cardiac stenting rose from 43 to 71 per cent of cases for patients with segment elevation myocardial infarction (STEMI) with a similar increase observed in New Zealand.”

For patients who underwent revascularisation (overcoming coronary artery blockages by cardiac stents or bypass surgery), the survival rate at seven years exceeded 80 per cent.

Dr Ranasinghe said despite the positives, the study did highlight continued concerns for three groups – those aged 85 and older, those who did not undergo revascularisation, and women in general.

Those aged 85 and older had a 17.4 per cent chance of living for seven years after a heart attack, while for all patients who did not undergo revascularisation, there was less than 45 per cent chance of surviving the same period.

“Older patients are often excluded from clinical trials, meaning we lack clarity about how to best treat these patients,” he said.

“Furthermore, less than a quarter of patients over 85 underwent a coronary angiography, a recommended test after an AMI that shows blockages in arteries.

“Clinicians were perhaps wary of the risks of harm from these invasive treatments, as patients often had several non-cardiac conditions and geriatric syndromes.

“Consistent with previous reports, survival was poorer among women and there were some regional variations in survival rates, suggesting disparities in care that warrant further investigation.”

While researchers had previously assessed short-term survival rates from heart attacks, this was the first time national data had been linked to determine long-term outcomes.

The study was funded by the National Heart Foundation of Australia and published in The Medical Journal of Australia (DOI: 10.5694/mja2.51085).