Octogenarians have more heart surgery, live longer

NEW YORK , 05 aug 2010-- Heart surgery and the use of other invasive treatments have risen sharply in elderly people who've suffered a heart attack, Canadian researchers said Tuesday.

In addition, the number of deaths within one year of those heart attacks dropped by almost 10 percent between 1996 and 2006, data from Quebec hospital patients aged 80 and older show.

"Over the last decade we are doing procedures in patients once believed to be too old for these procedures," said chest surgeon Dr. Mark R. Katlic, of Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Pennsylvania, who was not involved in the new study.

"It's my belief that this is a positive development," he said, cautioning that the study didn't prove the new treatment had reduced the number of deaths.

An earlier study found that U.S. heart patients of all ages are more likely to undergo procedures to clear blocked coronary arteries than are Canadians.

The current study, published in the Canadian Medical Association Journal, was carried out by Dr. Louise Pilote and colleagues of McGill University in Montreal.

Over a 10-year period, the researchers found that nearly 30,000 octogenarians in Quebec had suffered a heart attack.

In 1996, most of the patients received standard medications such as beta-blockers and cholesterol-lowering drugs, and only a few percent underwent invasive procedures.

Ten years later, however, that number had ballooned: A quarter of all patients were undergoing angioplasty, a procedure in which the doctor cleans out the blocked arteries that caused the heart attack.

Overall, almost half the patients died within a year of their heart attacks in 1996, while fewer than four in ten died in 2006.

The drop in mortality only occurred in patients who had undergone invasive procedures, suggesting those treatments might help patients survive longer. But it's possible that other changes in how doctors managed the patients could also have been involved.

Heart attacks kill more than 400,000 people in the U.S. every year according to the American Heart Association, and heart disease remains the leading cause of death.

Dr. Katlic, who wrote an editorial about the new study, said it was important to consider the cost of the procedures, which may amount to tens of thousands of dollars.

Medications are much less expensive, he told Reuters Health, but it's unclear if they are equally effective at preventing another heart attack.

"We should also study whether the quality of life is better after these procedures," he said.

SOURCE: link.reuters.com/ceh23n Canadian Medical Association Journal, online August 3, 2010.