Marking 20 years of groundbreaking treatment program saving lives when a heart attack strikes
The “race against time” is integral to the STEMI program, which is set up to treat patients quickly to save lives and prevent permanent heart damage. jazzirt via getty images
The University of Ottawa Heart Institute (UOHI) is marking this year’s Heart Month by recognizing a significant achievement – more than 20 years of operation for its innovative life-saving STEMI program. Developed for treating one of the most common forms of heart attack, the program has transformed emergency cardiac medicine and saved countless lives.
Two decades ago, a team of UOHI researchers led by intervention cardiologist Dr. Michel Le May put in place the groundbreaking protocol for treating people experiencing ST-segment elevation myocardial infarction (STEMI). It is usually caused by an artery that feeds the heart, called a coronary artery, that becomes suddenly blocked.
For several years before the program began, the UOHI team conducted research and built partnerships with other regional health providers to optimize the prospects for success.
Since the launch of the STEMI program in 2004, heart attack deaths have been reduced by 50 per cent in the Ottawa region. The findings were published in The New England Journal of Medicine in 2008, and to this day, the UOHI Regional STEMI Program serves as a model for other regions in Canada.
“At the onset of this type of heart attack, the clock starts ticking. The faster we act, the greater our chance of saving the patient and preventing permanent damage to the heart muscle. That means getting the patient to the catheterization lab as fast as possible to open the blocked artery. ”
A ticking clock
STEMI is a medical emergency, and without rapid intervention, one of the deadliest forms of heart attack. When it occurs, the critical task is to open up the blocked vessel and restore blood flow to the affected heart tissue with minimal delay.
“At the onset of this type of heart attack, the clock starts ticking,” says Dr. Le May, director of the University of Ottawa Heart Institute Regional STEMI Program. “The faster we act, the greater our chance of saving the patient and preventing permanent damage to the heart muscle. That means getting the patient to the catheterization lab as fast as possible to open the blocked artery.”
The STEMI program has embedded the “race against time” into every stage of the care delivery system. It has worked with partners throughout the region to ensure a co-ordinated response by all health providers interacting with a patient experiencing STEMI.
“Every step of the patient’s journey works in a seamless flow,” says Dr. Le May.
A citywide program was launched to direct all STEMI patients to the Heart Institute for advanced treatment. When a STEMI patient arrives at the emergency department of a hospital, they are rapidly transported to the UOHI. The program operates 24/7 and has expanded to include many hospitals outside the boundaries of the city.
Additionally, paramedics have been trained to identify these types of heart attacks right in the field, bypassing a trip to the emergency room. They call ahead to let the UOHI team know they are on their way to the Heart Institute.
As soon as the UOHI receives the call that a STEMI patient is en route, their specialized team members mobilize so they are ready to immediately begin treatment. In the catheterization lab, the team inserts a tube up to the heart and takes some pictures; once they find the blockage, they open up the artery with a balloon and then place a little wire mesh called a stent in the vessel to hold it open.
More than 10,000 patients have been treated through the STEMI program, averaging more than 500 per year.
“During Heart Month, it is especially gratifying to mark our achievements in improving emergency cardiac care through the STEMI program,” says Dr. Le May. “All of these are critical emergencies, and we are proud that we have been able to give thousands of patients the priceless gift of a future.”
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