Only 37% of patients suffering a major heart attack sought medical help within 60 minutes of the onset of symptoms, a report published today has found.
Calling 999/112 immediately at the start of heart attack symptoms results in faster treatment and improved outcomes.
This is one of the key findings in the Irish Heart Attack Audit National Report 2017-2020.
Approximately 6,000 people with heart attacks are admitted to Irish hospitals every year.
It is estimated that one quarter of these patients suffer a major heart attack, known as an ST elevation myocardial infarction (STEMI).
The gold standard treatment for these patients is primary percutaneous coronary intervention (primary PCI).
This involves inserting a wire into the blocked artery in order to open it with a balloon and stent, and should be performed in a timely fashion, defined internationally as equal to or less than 120 minutes from first medical contact.
Dr Ronan Margey is the clinical lead for the Irish Heart Attack Audit and he launched the report at the National Office of Clinical Audit annual conference.
Speaking on RTÉ's Morning Ireland, Dr Margey said: "These are really quite major heart attacks with catastrophic consequences if they're not addressed quickly."
Delayed treatment "translates into long-term complications with heart failure and death after heart attack".
He said that it is crucial that the blocked artery can be opened with a wire and balloon as soon as possible and blood flow restored to the heart muscle.
The mortality rate is almost double if a patient does not have this treatment within two hours.
Dr Margey said: "We're doing quite well by international comparisons. The mortality rate for STEMI is about 4.6%.
"That's slightly better than the last time that was looked at in 2016 and it's about on par with the findings in the United Kingdom and across Europe and the US.
"But actually, the timeliness with which people have their heart reopened really impacts their survival. So we talk about this golden 120-minute window from the time the patient makes contact with the emergency services to the time they have the balloon inflated in the artery to stop the heart attack.
"And if we can treat people within that golden 120-minute window, we really have a dramatic impact and what our audit shows is that if patients are treated in a timely fashion within that window, their mortality rate is 2.8%, as opposed to patients where there's a delay or where we missed that window and the mortality rate is 5.2%, so it's almost double. If there's a delay in that timeliness of delivery of care."
The Irish Heart Foundation responded to the findings with a call for the Department of Health to develop a new cardiovascular strategy.
"The Department of Health's Changing Cardiovascular Health: Cardiovascular Health Policy 2010 - 2019 established a framework for the prevention, detection and treatment of cardiovascular diseases, to reduce the burden of these conditions," said Dr Angie Brown, the charity's medical director.
"However, it has lapsed and unfortunately, has not been replaced with an updated policy, even though it covered prevention, clinical management of cardiovascular disease and all aspects of healthcare – from childhood through old age, from pre-hospital emergency care to rehabilitation and palliative care.
"The plan is now out of date and no formal review of the policy and the implementation of its recommendations has taken place.
"The scope and parameters of the current National Cardiac Services Review does not include a full and holistic approach to cardiovascular health, so preparations must begin for the development of a new Cardiovascular Health Policy, with a lead unit in the Department of Health."
Dr Brown added that a critical part of this new policy should be an increased focus on prevention and early diagnosis, as had been the case in the previous policy.
"We can see from the findings of the report, the need for a comprehensive and focused campaign on prevention and awareness, particularly around the symptoms of heart attacks as well as the risk factors particularly smoking."
