Research conducted by the Wayne State University Department of Emergency Medicine contributed significantly to a recent decision to change practice guidelines concerning treatment for certain heart attack patients. The guidelines were approved in early May and published recently in July by American College of Cardiology and the American Heart Association.

Mary Grzybowski, Ph.D., MPH, an assistant professor of emergency medicine, and her colleagues conducted a propensity analysis of 19,917 patients from an observational database who had suffered acute myocardial infarction and were eligible for mechanical reperfusion but had contraindications for thrombolysis. They found that patients who received immediate mechanical reperfusion were 48.5 percent less likely to die in the hospital.

The study, which was published in the Oct. 8, 2003, issue of the Journal of the American Medical Association, concluded that expediting blood flow through the vessels as quickly and efficiently as possible is critically important to the survival of patients in this situation. The results of this study provided enough evidence for the guideline for treating this type of heart attack to be rewritten. In fact, the intervention went from Class IIA recommendation (conflicting evidence but weight in favor of efficacy) to a Class I recommendation (evidence and/or general agreement that a given procedure or treatment is useful and effective).

"For those who practice medicine, 'evidence-based clinical practice' is something of a buzz phrase; this news proves how important it really is," Dr. Grzbowski said. "It's gratifying that the recent decision to change the guidelines validates our work, but more importantly, patients can greatly benefit from our work. "

Her colleagues included Elizabeth Clements, MD, Lori Parsons, BS, Robert Welch, MD, Anne Tintinalli MD, Mike Ross MD, and Robert Zalenski MD.