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Clot breaking drugs reduce death rates

SHARJAH - Heart attacks are the leading cause of death worldwide. More than 19 million people have a heart attack each year somewhere in the world. Heart attacks are the result of a partially blocked artery due to fatty deposits that form a clot.

Available clot breaking drugs like Streptokinase, Actilyse and Metalyse have brought down mortality rates from heart attacks to less than seven per cent, according to Dr A. K. Sen, Cardiologist at Zulekha Hospital.

Dr Sen spoke about artery blockages and the development of heart attacks at a medical seminar held recently in Sharjah in coordination with Novartis Pharma Services. He spoke on the need to go to hospital as soon as symptoms appear, like heaviness or discomfort in the chest.

He said clot-breaking drugs will not be very effective if a patient arrives after 12 hours of feeling discomfort in the chest. By 12 hours most of the heart muscle supplied by the artery gets damaged.

"We had a doctor who came very soon after chest discomfort and was found to have had a heart attack by ECG. He was immediately admitted and was given a Metalyse injection. He responded very well and the chest discomfort disappeared. He went home on the 5th day," Dr Sen said.

"Hospital management of heart attack has advanced a lot. We have clot breaking drugs, catheters which can break the clot, as well as other drugs like aspirin, plavix, low molecular weight heparins, ACE inhibitors and statins.

"Unfortunately half the patients of heart attack do not reach the hospital, they die either at home or on the way to the hospital. Hence all the advancement in hospital treatment is meaningless for them, hence the role of prevention. Now we are developing tests to know who is prone to a heart attack," Dr Sen said.

Among the tests used to determine who is at risk are blood sugar, cholesterol profile, markers for inflammation like CRP, markers of increased blood clotting tendency like fibrinogen, and PAI-1. Invasive methods like thermography, intravascular ultrasound, angiscopy and non-invasive methods like multi-spectral CT and MRI are also used.

"With proper use of these techniques, many of which are still developing, we can find the susceptible patients who are prone to heart attacks. Such patients can be advised to take preventive life-style changes and can be given preventive medicines.