According to official statistics released today1, residents of North West London, Hillingdon, Harrow and Hertfordshire who are taken to Harefield hospital after suffering a heart attack, get the fastest treatment in the country. While nationally the time for treatment after arriving at hospital is 56 minutes2, patients at Harefield are treated within just 23 minutes.
Patients at Harefield receive primary angioplasty – where a thin tube (catheter) is used to unblocked coronary arteries and a small metal stent put in place to keep the artery open. Primary angioplasty is used in increasing numbers of heart attack cases in the UK and as a result, patients are able to leave hospital sooner. Currently they stay for less than four days compared to five or six days with traditional drug-based treatments.
The Department of Health set out the case to move to a national primary angioplasty service for the treatment of heart attack in December 20063 and Health Minister Lord Darzi recently suggested that the pace of change needs to be further accelerated given the clinical evidence for primary angioplasty.4
Paramedics from the London and East of England Ambulance Services have undergone specialist training to identify patients who could benefit by being transferred directly to the Harefield Heart Attack Centre. The ambulances are met by a specialist cardiology team and the patient is taken directly to the catheter labs, where primary angioplasty is carried out immediately.
Commenting on the publication of the new statistics, Dr Miles Dalby, consultant cardiologist at Royal Brompton & Harefield NHS Trust, said: “For anyone who has suffered a heart attack, the speed of treatment is vital. During a heart attack, blood flow to the heart muscle is blocked. The sooner the patient receives treatment enabling the blood flow to return to the coronary arteries, the less damage occurs. This gives better long-term results - time is muscle.
“We have worked hard to develop a service at Harefield’s Heart Attack Centre which ensures expert treatment in record time. Other regions around the country who are keen to adopt a similar approach regularly contact us and attend our training sessions and conferences. We look forward to seeing a rapid expansion of high quality primary angioplasty services throughout the UK.”
 2008 report of the Myocardial Ischaemia National Audit Project (MINAP)
 Median time in England and Wales
 Mending heart and brains. DH 2006.
 Our NHS, our future. DH 2007.
Notes to editors:
1. The catchment area for Harefield Hospital’s primary angioplasty service covers Hillingdon, Harrow, West Hertfordshire, Barnet, Luton, East and North Hertfordshire, Hounslow, Ealing and Brent.
2. The 2008 report of the Myocardial Ischaemia National Audit Project (MINAP) can be accessed via: http://www.rcplondon.ac.uk/
3. In June 2007, research presented at the British Cardiovascular Society’s Annual Scientific Conference showed that many heart attack patients are more likely to survive if paramedics take them directly to specialist heart attack centres for emergency primary angioplasty, rather than local accident and emergency departments for traditional clot-busting (thrombolysis) treatment. Harefield Hospital consultant cardiologist Dr Miles Dalby and his colleagues compared the outcome of 180 patients who received direct primary angioplasty at Harefield Hospital in Middlesex to the outcome of 181 patients who received the thrombolysis treatment at district general hospitals in the preceding two years. The results showed that direct primary angioplasty with rapid arrival-to-treatment times had a significantly higher survival rate than thrombolysis.
4. The research highlighted the need for rapid treatment, showing that while a less than 3 per cent, 30-day mortality rate for primary angioplasty was achieved when patients were taken directly to Harefield by ambulance, those who went to district general hospitals first and were later transferred to Harefield for primary angioplasty had a much higher mortality rate.
5. Royal Brompton & Harefield NHS Trust is a centre for excellence in the research, diagnosis and treatment of heart and lung disease. It is a national and international referral centre for patients of all ages.
For further information please contact:
Joanna Parish/Jo Thomas
Royal Brompton & Harefield NHS Trust
0207 351 8672/8850 Out of hours via switchboard - 0207 352 8121