OLDER heart attack patients in Scotland are being sought as part of a new clinical trial exploring whether over-75s should be routinely offered surgeries to clear blockages in their arteries.
Half of heart attacks occur in people aged 72 and over, but there are conflicting views on how best to treat older patients.
Currently, 86 per cent of older patients aged 85 or older who have a heart attack are given medication to treat their condition, instead of medication combined with a procedure known as a coronary angioplasty, which clears blockages in the heart arteries using a balloon and a metal scaffold, known as a stent.
This is compares against 17 per cent of patients aged 18 to 65 years old.
Many clinicians believe older patients are frail, have a lower chance of survival and are more likely to have complications after heart procedures. However, this is based on perception rather than evidence-based research.
The issue is becoming more pressing in the face of an older population where many more people will live into their 80s and 90s, increasing the number of heart attacks in this age group.
Now researchers from Edinburgh University are to take part in a £1.7 million clinical trial funded by the British Heart Foundation (BHF), which will investigate if current UK practices should change.
The study aims to find the most suitable way to treat patients aged 75 and over who have had a heart attack.
Professor David Newby, the BHF professor of cardiology who will lead the Edinburgh team, said: “There is much debate and conflicting views amongst doctors about how to treat patients over 75 years old who present with a heart attack. This is because of the lack of evidence in older patients who may have both benefits and harms from treatments.
"As people are now living longer, it's really important we carry out this research to identify how best to manage our patients to ensure they receive the best care available and enhance their chances of recovery."
Coronary heart disease (CHD) is Scotland’s single biggest killer and the leading cause of death worldwide. CHD is responsible for the deaths of nearly 7,000 Scots each year and most of these are caused by a heart attack.
The UK-wide trial, known as SENIOR-RITA, hopes to find 2,300 patients across 40 different hospitals across the UK over a two-year period to take part in the trial.
The clinical trial will look to determine whether patients over the age of 75 will benefit from a coronary angiography and angioplasty after having a minor heart attack. Patients on the trial will be randomised to have either the procedure alongside medication or receive medication in keeping with the current practice.
Brian Thompson, who is 83, had a stent fitted as part of the first phase of the trial in Newcastle in the summer.
He said: “I had my heart attack in June of this year and I’m very lucky that I’ve been able to carry on with my life with my wife. It made sense for me to take part in the trial as it will help doctors make better decisions for patients like me. It has been a good experience dealing with the doctors and research nurses at the Freeman Hospital. I’ve also had the opportunity to see my own scans and talk to them about my heart and what we will be doing going forward. It feels good to know that I’m part of something that will help not just people in my generation, but for those in the future as well.”
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