More experienced doctor ups heart attack survival

June 29, 2001

By Mulvihill

NEW YORK, Jun 26 (Reuters Health) - Being treated by a highly experienced

doctor after a heart attack could mean the difference between life and

death, according to a new study out of Canada.

Researchers found that among more than 98,000 heart attack patients, those

with doctors who treated five or fewer heart attacks a year were more likely

to die within 30 days compared with those whose doctors cared for a least 24

heart attack patients a year.

The findings are published in the June 27th issue of The Journal of the

American Medical Association.

" We found that a patient's likelihood of surviving a heart attack was

strongly influenced by the experience of their physician, " lead author Dr.

Jack V. Tu, of the University of Toronto, told Reuters Health. " Patients

whose doctors treat more heart attack patients each year are more likely to

survive their heart attacks. "

Tu's team reviewed the records of patients treated by nearly 5,400 doctors

in Ontario hospitals. The 30-day mortality rate was less than 12% for

patients treated by doctors who cared for at least 24 heart attack cases a

year, compared with more than 15% among patients of doctors who treated five

or fewer heart attack cases each year.

After 1 year, 24% of patients treated by the less-experienced doctors had

died, compared with fewer than 20% of those treated by the more-seasoned

physicians.

In addition, Tu noted, experienced doctors were more likely to prescribe

medications that improve survival odds, such as aspirin and beta-blockers.

" Patients who are suffering from a heart attack should go to their nearest

hospital, " Tu said, " but once they get there, they may want to request that

they are treated by physicians with a lot of experience in treating heart

attack patients. "

He added that this study is the " largest and most comprehensive " to date

looking at the issue of physician experience and heart attack survival.

" This...phenomenon is not widely known in the medical community, " he said.

Tu also stressed the fact that heart attacks are one of the " most

complicated and lethal conditions that physicians have to treat and the

optimal treatment is changing constantly. "

He noted that physicians who treat heart attack patients on a regular basis

are more likely to be aware of and use optimal treatment strategies.

" In medicine and surgery, " he said, " practice makes perfect. "

SOURCE: The Journal of the American Medical Association 2001;285:3116-3122.

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