(June 24, 2009 - Insidermedicine) High risk patients who experience a heart attack and who receive clot busting drugs are still better off undergoing an invasive procedure to open blocked vessels as soon as possible rather than receiving drug therapy and taking a "wait and see" approach, according to research published in the New England Journal of Medicine.

Here is some information about the treatment of heart attacks:

•    When a heart attack is caused by a blockage in the blood vessels that feed the heart, time is of the essence, as reopening the blood vessel can lower the chance of death

•    Angioplasty is a procedure in which a balloon-tipped catheter is threaded into a blood vessel feeding the heart in order to open blockages

•    Another treatment for heart attack is th euse of "clot busting" drugs that dissolve the blockage

Researchers representing the TRANSFER-AMI Trial Investigators recruited over 1,000 high risk patients who suffered a heart attack and who received clot busting drugs at a healthcare facility that could not conduct PCI. These patients were randomly assigned to be immediately transferred to another hospital for PCI or to remain where they were and be treated with drug therapy alone. These patients could, however, receive PCI if it later became apparent that it was essential.

In the end, nearly 89% of the patients assigned to drug therapy alone eventually received PCI, generally within a couple of days. One month later, those patients assigned to drug therapy were more likely than those assigned to immediate PCI to experience complications from their heart attack, including a second attack, worsening heart disease, or even death.

Today's research suggests that PCI should not be delayed among high risk patients who experience a heart attack, even if they receive drugs that dissolve blood clots.

For Insidermedicine in Depth, I'm Dr. Kelly Schweitzer.