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Access to primary angioplasty to treat acute myocardial infarction in Europe: overcoming barriers, addressing inequalities



Acute ST-myocardial infarction, (heart attack), is still one of the main killers in the world. The European Society of Cardiology recommends the use of Acute Primary Percutaneous Coronary Intervention (also know as acute balloon angioplasty) as the first choice of treatment for patients with heart attack, if performed by an experienced centre.

Despite substantial evidence of its effectiveness, only 40 to 45 per cent of European heart attack patients are treated with acute balloon angioplasty, with wide variations at national level ranging from 92 per cent of heart attack patients in some countries to just 5 per cent in others.

Why access to primary angioplasty needs to be improved

Cardiologists and other experts explain how improving access to life-saving therapies for acute heart attack patients across Europe has multiple benefits for patients and health systems.


In an attempt to address these discrepancies, ECCF funded a European research project led by the Departments of Cardiology and Clinical Epidemiology at Aarhus University Hospital in Denmark. The study looked at the interplay between technology, patients, policy makers, culture and resources. Read the full report here.

The research went on to investigate whether health care-associated economic and demographic country-level characteristics were associated with variations in the utilization of angioplasty, and examined 5-year trends in the implementation of angioplasty for acute heart attack patients across 12 EU countries. The research suggests that variation in the use and rate of uptake of angioplasty between countries were associated with supply factors such as the numbers of beds and physicians, rather than patient-level factors, country-level finances or healthcare characteristics. read the full report here.

However lack of comparable Europe-wide data on other key variables, for example transport times, may be the most significant finding of this research, without which health providers are hard pressed to implement measures for improvement.


Aspects of myocardial infarction

Interplay of factors within a country determining the delivery of acute balloon angioplasty to heart attack patients.



Click here to read about ECCF’s activities to overcome barriers in access to best treatment for heart attack patients in Europe


Fast facts


  • The annual incidence of hospital admission for acute heart attack patients varies across Europe between 90–312 per hundred thousand per year.

  • Scientific research has clearly shown that use of primary angioplasty can better reduce the risks of mortality, reinfarction and stroke, over other treatments.  The European Society of Cardiology (ESC) guidelines therefore recommend this as the preferred treatment whenever it is available within 90-120 minutes of the first medical contact.

  • The use of primary angioplasty to treat acute heart attack patients across Europe ranges between 5 and 92 per cent of all heart attack patients.

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