NEW YORK (Reuters Health) - A new international study has found a major reduction in the risk of death or heart failure after heart attack since 1999.

The improvements are due to better adherence to "evidence-based" guidelines on caring for these patients, from wider use of aspirin and other blood thinners to more systematic use of surgical interventions to clear blood vessels in high-risk patients, Dr. Keith A. A. Fox of the University of Edinburgh, Scotland, told Reuters Health.

And the improvements were not limited to the most sophisticated medical centers. "This is a real-world population in all the spectrum of hospitals, from community hospitals to interventional centers, so it's not cherry picking," Fox said.

He and his colleagues analyzed data from the Global Registry of Acute Coronary Events, which included 44,372 patients with acute coronary syndromes (ACS), such as heart attack, treated in 113 hospitals in 14 countries. The goal was to see if changes in hospital management of patients with ACS are associated with better outcomes.

From 1999 to 2006, the researchers found that use of drug therapies and surgical interventions increased markedly and the risk of death or "new" heart failure was cut in half.

The study is the first, Fox said, to show a reduction in new heart failure due to changes in treatment.

"It's reassuring in fact to know our guidelines are on the right track, because by applying them we're seeing this difference," Fox said.

"The next steps are tough ones, but it's to ensure that in every one of these hospitals we narrow the gap between the evidence and the treatment."

SOURCE: Journal of the American Medical Association, May 2, 2007.

REUTERS