Fewer patients called for emergency service help within an hour of heart attack symptoms last year compared with the previous year, according to a new report.
Just 45% of patients called emergency services for assistance within an hour of symptom onset, down from 49% in 2023.
Fewer patients also received the recommended best practice hospital treatment to restore blood flow.
The report from the National Office of Clinical Audit looked at data from 1,615 patients and advised that early symptom recognition and appropriate action is key to faster treatment.
It points out that Primary Percutaneous Coronary Intervention (PCI), the treatment to restore blood flow, is the internationally preferred best practice therapy for people with a major heart attack.
However, the report says this hospital treatment was given to just 77% of eligible patients, down from 86% in 2017.
In addition, just 61% of patients received this treatment within the recommended two hours after a heart attack is diagnosed.
The audit found that just 35% of patients presenting with a major heart attack to a centre which performs PCI treatment in Ireland have an ECG (electrocardiogram to check the electrical activity of the heart) within 10 minutes.
It says that the ambulance transfer times of patients with this type of heart attack to primary major heart attack treatment centres are too long.
The audit points out that smoking remains a major risk factor and causes heart attack at a much younger age.
Around 36% of patients presenting with a heart attack were current smokers and smokers experienced a heart attack on average 11 years earlier than non-smokers.
Other key cardiovascular risk factors were high blood pressure and high cholesterol.
National Clinical Lead of the Irish Heart Attack Audit Professor Ronan Margey said that its latest report highlights the need for a renewed focus on public awareness, system-level process improvement and targeted risk factor management to reduce the incidence and improve the treatment of ST elevation myocardial infarction (SEMI).
He said that the system is most effective when every step, from recognising symptoms to calling for help, diagnosis, transfer and treatment, happens without delay.
Speaking on RTÉ's Morning Ireland, Prof Margey said that too many people wait to go to the emergency department and can miss getting treatment in the critical first 120 minutes, which is vital for a positive outcome.
"We see the people who are treated within that 120-minute window have only a 4% mortality in hospital, which is phenomenal, as best as anywhere else in the world," he said.
Prof Margey said the audit shows that there is not enough ambulance resources to move people rapidly enough between hospitals, adding, that "with this recommendation today, we're clearly highlighting that there will need to be an improved resourcing of the ambulance service, both in personnel and in units on the road, so that we can more rapidly move these people with serious medical problems".
In response to the report, the HSE said that in the last ten years, over 15,000 patients having a major heart attack have been treated with immediate coronary balloon angioplasty/stenting - the internationally recommended intervention.
The HSE said that as a result, death from major heart attack has almost halved, from about 7.4% to 4.1%, saving hundreds of lives.
It added that the latest report confirmed that the death rates for this type of heart attack are within the predicted range for Ireland's population, based on age, sex and ethnicity.
