Fortunately for people suffering heart attacks, there have been significant advances in treatment. But along with the advances comes the need to make a choice: which is the better treatment for you -- angioplasty or clot-busting drugs?

Of course your doctor is in the best position to help you make that decision. But you should know that research studies are finding lower mortality rates among those who receive angioplasty. Two such studies were recently reported in the Journal of the American Medical Association and the American Heart Journal.

One study analyzed mortality by procedure and by the number of procedures performed at the hospital. It reported fewer deaths among patients receiving angioplasty at hospitals doing an intermediate or high volume of procedures. At hospitals classified as high volume (doing more than 4 angioplasties/month), the mortality rate was 3.4% for patients receiving angioplasty, compared to 5.4% for those who were given clot-busting therapy. There was no difference, however, between the 2 treatments in patients treated at hospitals doing a low volume of angioplasties.

The other report was an analysis of many articles from the medical literature. It, too, found that people who've had a heart attack fare better if they receive an angioplasty than if they receive clot-busters. This is especially true in patients who:

• Are elderly
• Have had coronary bypass surgery
• Have congestive heart failure
• Are in cardiogenic shock.

Sources:

• Magid DJ, Calonge N, Rumsfeld JS et al. Relation between hospital primary angioplasty volume and mortality for patients with acute MI treated with primary angioplasty vs thrombolytic therapy. Journal of the American Medical Association, Dec. 27, 2000. (Abs.)
• DeGeare VS, Dangas G, Stone GW, Grines CL. Interventional procedures in acute myocardial infarction. American Heart Journal, January 2001. (Abs.)