New Study Shows Standardized Heart Attack Protocols Can Reduce Deaths by 50% and Eliminate Gender Gaps in Care


“Any hospital anywhere in the world can implement these straightforward protocols to help to improve patient outcomes,” says expert from a top American hospital Cleveland Clinic on World Heart Day, September 29

Dr. Umesh Khot, Head of Regional Cardiovascular Medicine at Cleveland Clinic

Cleveland, Ohio: A new series of protocols for treating patients with the most severe types of hearts attacks can reduce deaths by more than 50%, and eliminate gender disparities in care and outcomes, according to a new study by Cleveland Clinic. The hospital has been number one in heart care in the U.S. for 27 consecutive years in News & World Report’s ‘Best Hospitals’ rankings.  

Dr. Umesh Khot, Head of Regional Cardiovascular Medicine at Cleveland Clinic, and senior author of the study, said: “Women worldwide have a higher chance of dying and major medical complications after a serious type of heart attack called STEMI, when one of the arteries is 100 percent blocked. Our study standardized the same high level of care regardless of the patient’s sex, eliminating gender disparities and significantly reducing deaths. Each patient benefits differently, and by combining all four of the recommendations, any hospital anywhere in the world can implement these straightforward protocols to help to improve patient outcomes.”

The study, newly published in the European Heart Journal Open as a follow-up to the original study in the Journal of the American College of Cardiology in 2018, examined patients at 10 hospitals over a five-year period. The study focused on minimizing variability in care for patients with STEMI (ST-Segment Elevation Myocardial Infarction), a life-threatening type of heart attack that is caused when one of the heart arteries is fully blocked.

The protocols include: (1) standardized emergency department cardiac catheterization lab activation criteria, (2) a STEMI safe handoff checklist, (3) immediate transfer to an available catheterization lab, and (4) using the radial artery in the wrist as the first option for under-the-skin coronary intervention, like stenting, instead of through the groin.

The study looked at 1,833 consecutive STEMI patients at 10 of Cleveland Clinic’s hospitals in Northeast Ohio from 2014-2019. Separately, patients treated from 2011-2014 were studied as a control group.

Thanks to implementing these protocols, Cleveland Clinic eliminated the gender disparities in care, mortality and in major adverse events. Women also had a more than 50% reduction in the risk of dying in the hospital with a STEMI heart attack. Still, gender disparities remain – women still faced a significantly higher rate of bleeding even after the STEMI protocols, and researchers are continuing to examine ways to reduce the bleeding issue.

Cardiovascular diseases are the leading cause of death worldwide, with 17.9 million deaths per year, according to the World Health Organization. Previous studies have shown that women with STEMI traditionally had worse clinical outcomes, including higher mortality and higher rates of serious complications such as recurrent heart attack or stroke.

Samir Kapadia, M.D., chairman of Cardiovascular Medicine at Cleveland Clinic, added, “This study shows that excellent processes and expert care can provide uniform expeditious care to all patients with this type of serious heart attack, resulting in unparalleled outcomes.”

About Cleveland Clinic:

Cleveland Clinic – now in its centennial year – is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 70,800 employees worldwide are more than 4,660 salaried physicians and researchers, and 18,500 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 19 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2020, there were 8.7 million total outpatient visits, 273,000 hospital admissions and observations, and 217,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries.