Patient Initiated Emergency Response System
The Problem
More than one million Americans will suffer an acute myocardial infarction (AMI) this year. Within the first 60 minutes of chest pain, 250,000 will die. Before reaching any medical attention, a total of 375,000, (one-third) will die.
While thrombolytic therapy saves
more than 20,000 lives per year compared with placebo, and while primary percutaneous
coronary intervention (PCI) saves an additional
20,000 lives per year over thrombolytic therapy (representing a more than 50% relative
reduction in AMI mortality compared with placebo), this number of lives can be saved by a
12% relative reduction in mortality in the
pre-hospital phase of AMI. Thus, strategies
having even a small relative benefit result in a large reduction in mortality, because of
the staggering number of individuals at risk.
(click pictures to enlarge)
As
shown, time-to-treatment is an important
predictor of mortality in AMI. The benefit of
thrombolytic therapy drops off rapidly as a function of increasing time between symptom
onset and application of therapy, particularly early in the course of AMI. Together, the data in the figures strongly suggest
that efforts aimed at reducing the delay between AMI onset and therapy can reduce
mortality significantly. This is the impetus
behind the National Heart Attack Alert Program (NHAAP).
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