September 30, 2021 – A five-year follow-up study confirms that a Cleveland Clinic-developed protocol improved outcomes for the most severe type of heart attacks – not only reduced mortality in both men and women, but eliminated or reduced the gender disparities in care and outcomes typically seen in those cardiac events.
In the original study, Cleveland Clinic researchers implemented a comprehensive four-step protocol for STEMI patients designed to minimize variability in care. The protocol included:
- Standardized emergency department cardiac catheterization lab activation criteria
- A STEMI safe handoff checklist,
- Immediate transfer to an available catheterization lab
- Using the radial artery in the wrist as the first option for percutaneous (under the skin) coronary intervention, like stenting.
Cleveland Clinic says that this approach resulted in fewer bleeding complications and improved survival when compared to using the femoral artery.
According to Cleveland Clinic, results of the five-year study showed the following:
- Use of guideline-directed medical therapy and door-to-balloon time were similar between males and females after implementation of the STEMI protocol.
- There were major improvements in using the radial artery in the wrist as the first option for percutaneous coronary intervention in both males and females, although a lower rate was seen in females after protocol implementation.
- Sex disparities in mortality and major adverse events were no longer observed after protocol implementation.
- Women had a more than 50% reduction in the risk of dying in the hospital with this heart attack.
- A significantly higher rate of bleeding in females persisted despite implementation of a STEMI protocol, including promotion of using the radial artery in the wrist as the first option for percutaneous coronary intervention.