TORONTO - Progress is being made in the fight against one of the leading causes of death in Canada, with new statistics Thursday showing that fewer Canadians are dying from heart attacks after being admitted to hospital.
The hospital admission rate for heart attack patients in Canada (excluding Quebec) dropped 13 per cent over five years, says the annual Health Indicators report by the Canadian Institute for Health Information.
And for those who do suffer a heart attack and are admitted to hospital, the outcomes are better.
Death rates in hospital within 30 days of admission were down 11 per cent in the five-year period ending in 2007-2008. And unplanned readmissions to hospital after a heart attack fell by 31 per cent.
"What we believe is that some of our primary prevention efforts are finally paying off ... we're finally getting to people and having them stop smoking," said Dr. Marino Labinaz, director of the Cardiac Catheterization Laboratory at the University of Ottawa Heart Institute.
"I think we are more attuned to exercise and we're more attuned to treating elevated cholesterol - we have better drugs now than we had, you know, a decade ago."
A couple of root causes are probably behind the declines, said Helen Angus, vice-president of research at the institute. She cited improved awareness of some of the risk factors, such as smoking, and better cardiac care.
Labinaz doesn't think there is one simple answer to explain why survival has improved in recent years, but rather a multitude of reasons.
"It's gone from developing rapid models to get patients who are having heart attacks to the cardiac catheterization laboratories, where they're undergoing angioplasty and stent procedures, to having better guidelines about what medications patients should be taking after heart attack to more intense rehabilitation after the heart attack," he said in an interview.
In the Ottawa area, for instance, paramedics have been trained to interpret electrocardiograms and take anyone who appears to be having a high-risk heart attack directly to the catheterization lab where angioplasties are performed, bypassing the emergency department.
"So you're removing a lot of middlemen, or middle people, along the way, which delays therapy. And we've learned the faster you treat the heart attack, the better the outcomes," Labinaz said.
Doctors in the Ottawa area have noticed a 50 per cent reduction in the risk of patients dying from a heart attack within 30 days of being admitted.
Labinaz said Calgary has a similar program and a low mortality rate.
There were just over 51,000 heart attacks in 2004-05 reported by Canadian hospitals, and the number was about the same in 2007-08, according to Angus.
"So the number's holding steady while the population is growing and aging, so I think we're seeing a real improvement here," Angus explained.
But the report does not contain information on how many Canadians die before reaching a hospital. According to the Heart and Stroke Foundation's website, more than 17,000 Canadians die each year as the result of a heart attack, and most of these deaths occur out of hospital.
The CIHI report also found:
-Rates of stroke declined 14 per cent, but the risk of dying in hospital within 30 days of admission remained at 18 per cent.
-Stroke patients who saw a neurologist or neurosurgeon were 40 per cent less likely to die in hospital than those not treated by a specialist.
-The rate of hip fractures in the community dropped 21 per cent from 1998 to 2008, but the risk of fracturing a hip while in hospital has not changed much since 2003. About 600 seniors break a hip while in an acute-care facility each year.
-The rate of caesarean sections increased from 22.5 per cent in 2001-02 to 27.7 per cent in 2007-08. The rates are highest in B.C. and P.E.I. (more than 31 per cent) and lowest in Nunuvut, at 6.7 per cent.
