Metro Detroit health systems: New heart attack treatment saving lives
Cardiologists from five Metro Detroit health systems said Wednesday a new heart attack treatment pioneered in Detroit can dramatically increase the survival rate of patients in cardiogenic shock, a devastating side effect of heart attacks.
Results of an unprecedented collaboration by the region’s five major hospital systems will be presented in March at the annual American College of Cardiology Scientific Sessions in Washington, D.C. The cardiologists said they decided to announce their results early because lives can be saved if doctors implement the treatment immediately.
Among the patients fitted with a tiny heart pump — as quickly as eight minutes after arrival in one case —80 percent survived, or 24 of the 30 patients. That compares with the traditional survival rate of 50 percent, according to health system representatives.
Cardiologists at participating hospitals inserted the pump, about the diameter of a pencil, into a patient’s heart as soon as possible upon arrival at the hospital. Approved by the federal Food and Drug Administration last spring, the Impella pump helps keep oxygen-rich blood moving through the patient’s body at a sufficient pressure to protect the body’s organs while doctors treat the cause of the heart attack.
Since the trial started in July, doctors at the hospitals identified 30 patients who were appropriate for the treatment because they were having a heart attack accompanied by cardiogenic shock. It is a condition that occurs when the heart is severely depressed, causing low blood pressure that deprives vital organs of sufficient blood supply to survive.
Historically, cardiologists have used a combination of medications and mechanical support to keep blood moving, but current methods often don’t keep enough blood flowing at sufficient pressure to keep vital organs alive, doctors said.
The collaboration was initiated by Dr. William O’Neill, medical director of the Center for Structural Heart Disease at Henry Ford Hospital in Detroit.
O’Neill was the principal investigator in clinical trials of the Impella pump, developed by Danvers, Mass.-based medical device developer Abiomed. He said he is not paid by Abiomed and doesn’t hold any financial interest in the company.
O’Neill said he saw the life-saving potential of the pump during FDA-approved clinical trials between 2005 and 2012.
Since then, cardiologists are only marginally aware of the benefits of the device, so O’Neill said he wanted to show the Impella could improve survival if used routinely as an initial step in treatment for patients with cardiogenic shock.
“(Cardiologists) know it exists, but its being infrequently used,” O’Neill said following the press conference at Henry Ford Hospital. “Nobody was systematically using it or introducing it early.”
Two patients joined doctors Wednesday -- Dan Rolston, 49, of Wyandotte and Nate Thomas, 63, of Ferndale. Both survived cardiogenic shock when doctors at Beaumont Hospital in Royal Oak used the pint-sized pump.
“There is no question in our minds that early circulatory support is critical to improve the chance of a successful outcome in these critically ill patients,” said Dr. Simon Dixon, chair of Cardiovascular Medicine at Beaumont.
Dr. Thomas Lalonde, chief of cardiology at St. John Hospital in Detroit, described the Impella as “the smallest artificial heart pump known to man.”
“It has a very simple benefit to us — that is to maintain (blood) flow,” Lalonde said, explaining the device is inserted through the groin into a main artery and then into the main pumping chamber of the heart. It’s powered by a console outside the body and keeps blood circulating at a volume of 2.5 to 3.5 liters per minute.
“The beauty of this, especially when you insert this device initially, is it provides blood to all vital organs of the body, most important is the liver and the brain, and it allows us time to open up” and treat the blood clot or other cause of the heart attack, Lalonde said. “It’s a very, very incredible and sophisticated device.”
Dr. Theodore Schreiber, president of Detroit Medical Center Heart Hospital, said “while these findings are quite preliminary, they are very exciting because for the first time in a few decades we’ve found a way to save lives.”
“This is a very dramatic accomplishment,” Schreiber added, saying “thousands” of lives can be saved if the practices from the initiative are adopted as best practices in cardiac care nationwide.