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Lifesaving heart attack treatment replicated nationally

Posted: 5/29/2019

Groundbreaking study at Vassar Brothers Medical Center and others shows increased survival

Patients with a deadly heart attack complication nationally survived at significantly higher rates when treated with a specific protocol offered at Vassar Brothers Medical Center (VBMC), according to trial results recently announced.

VBMC was one of 65 sites enrolled in the National Cardiogenic Shock Initiative (NationalCSI) study that showed 72 percent of patients with cardiogenic shock survived their heart attack when treated with the protocol. Researchers announced the trial results at the Society for Cardiovascular Angiography and Interventions (SCAI) 2019 Scientific Sessions. Typical survival rate from this deadly complication has historically hovered around 50 percent.

“VBMC is pleased to help move the needle in survival from heart attacks,” said Dr. Simon Gorwara, Chairman of Cardiology at VBMC, who is leading the protocol implementation at the Poughkeepsie hospital. “We’ve worked together as a team to implement this protocol, and we’re happy to see the results in our patients.”

In heart attack patients experiencing cardiogenic shock, the heart is too weak to pump blood to vital organs and the rest of the body. The scenario deprives vital organs of sufficient blood supply, causing them to go into shock and, eventually, cease functioning.

The protocol, available at henryford.com/cardiogenicshock, entails quickly recognizing the condition, then inserting a straw-sized pump into the heart to keep blood flowing throughout the body. The Impella pump, an FDA-approved device, is inserted through a catheter in the groin as soon as the patient arrives at the hospital. Doctors then treat the cause of the heart attack, either inserting a stent, removing a clot or taking other necessary action.

“Our interventional cardiology program at Vassar is accomplishing some amazing things. Lifesaving emergent minimally invasive opening of blocked arteries has completely changed the paradigm for patients having heart attacks. The sickest patients with heart attacks, however, are the ones with cardiogenic shock and traditionally outcomes in this patient population have been disappointing. We were honored to participate in this study and help move the bar toward improved survival in these critically ill patients in our community,” Gorwara said.

National study results released involved doctors across the country at sites ranging from community hospitals to large academic centers. They used the protocol to treat 171 patients — 77 percent male with an average age of 63 years — between July 2016 and February 2019. They also isolated predictive markers that indicate a patient’s condition, an invaluable tool in determining treatment.

NationalCSI researchers and cardiologists based at Henry Ford Hospital in Detroit are leading the study, the first large-scale clinical trial of a national cardiogenic shock treatment protocol. It is the second iteration of a smaller pilot study conducted in southeast Michigan and is expected to continue at VBMC and other locations for at least two more years.

“We’re very pleased these preliminary trial results show this protocol can be replicated in many different hospital settings to improve survival in cardiogenic shock,” said Henry Ford Health System cardiologist Dr. Babar Basir, who is leading the effort in Detroit with pioneering cardiologist William W. O’Neill.

O’Neill, medical director of the Henry Ford Health System Center for Structural Heart Disease, said he expects continued improvements could raise the survival rate to greater than 80 percent.

“Even though every hospital has their own standards, we found that when physicians across the country recognize the signs of shock early and follow this protocol, it can save lives,” O’Neill said. “We’re honored to be part of this life-saving work.”

For more information about the cardiogenic shock program at VBMC, visit https://healthquest.org/clinical-research/heart-failure-clinical-trials.aspx.

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