CLARKSBURG -- For years, the standard for treating a heart attack was an injection of clot-busting drugs. But that standard is slowly changing.
Now, most experts agree, primary angioplasty, in which a small balloon is inserted into the affected artery to break up the clot, is the way to go.
The biggest problem with that is that the procedure is typically only available at larger medical centers, not the smaller community hospitals.
With West Virginia among the nation's leaders in obesity, tobacco use, diabetes and sedentary lifestyles, a better way to treat heart attacks should be welcomed with open arms. But the revolution is slow in coming.
Currently, just eight hospitals -- all in the northwestern part of the state -- are approved to perform angioplasties. That leaves a big gap and lots of concerns for people in other regions of West Virginia.
One of those facilities is WVU Hospitals in Morgantown, which has been performing angioplasties for about six years.
Heart attack patients who come to WVU Hospitals are taken directly to the cath lab for the procedure, said Dr. Bradford Warden, interventional cardiologist and assistant professor of medicine.
It becomes a little trickier, however, when a patient is coming from farther away.
"When you're looking at an hour and a half to two hours, we recommend thrombolytic treatment and then follow up with angioplasty," Warden said.
Many studies have shown the benefits of angioplasty as opposed to thrombolytic treatment, or clot-busting drugs. One recent study from the University of Michigan, however, appears to show that the benefits of angioplasty are closely tied to the timing of the procedure.
According to the study, if a patient can have angioplasty less than an hour sooner than the drugs, the instances of stroke, repeat heart attacks and other complications are significantly reduced. Once the time difference exceeds an hour, the two treatments are virtually equivalent.
"Primary angioplasty shortens the patients stay in the hospital," Warden said. "Studies have shown that it saves more of the heart muscle by returning good blood to the heart faster."
Partly because of the encouraging studies, the state's Health Care Authority last year began a pilot program to expand the number of hospitals approved for the procedure.
"The technology has evolved to the point where angioplasty can be done much more safely in a community hospital setting, and by that I mean hospitals that don't have open heart surgery," said authority chair Sonia Chambers.
Three hospitals received the initial certificates of need for the angioplasty pilot program: Weirton Medical Center has been performing the procedure for about a year; St. Francis Hospital in Charleston about six months; and United Hospital Center about four months.
Other hospitals that perform angioplasty are Charleston Area Medical Center, St. Mary's Hospital in Huntington, WVU Hospitals, Monongalia General Hospital and Wheeling Hospital. All those facilities also have open heart surgery programs.
While other studies have shown the benefits of angioplasty, Chambers said it's still too soon to tell the impact in West Virginia. The authority is conducting a study of its own, she said, comparing the outcomes of angioplasty patients at the pilot hospitals to patients at the other facilities. The authority also may compare angioplasty patients with those who received clot-busting drugs.
"Basically, we're now trying to examine the success of angioplasty, because there are other hospitals around the state that are interested," she said.
Staff writer Jim Fisher can be reached at 626-1446 or by e-mail at firstname.lastname@example.org