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Elderly Patients Don’t Always Get Heart Treatment

Many elderly heartattack victims do not receive potentially lifesaving treatments such as clot-busting drugs and blood thinners, and some aren’t even told to stop smoking, according to a study.

The possible reasons: the complexity of treating heart disease in elderly people and a lack of oversight in hospitals, said the study’s lead author, Dr. Edward F. Ellerbeck, a medical officer in the Baltimore office of the Health Care Financing Administration, which runs Medicare, the health-insurance program for people over 65.

“Each year, Medicare beneficiaries have more than a quarter of a million heart attacks,” HCFA Administrator Bruce C. Vladeck said in a statement.

“If we can bring their care up to best practices, we should be able to save thousands of lives.”

Researchers analyzed records of 16,124 Medicare patients at hospitals in Alabama, Connecticut, Iowa and Wisconsin from June 1992 through February 1993.

Only 69 percent of ideal candidates for clot-dissolving drugs got them, according to the study published in today’s issue of The Journal of the American Medical Association.

With blood thinners, the proportion was 70 percent; with aspirin, 83 percent; with stop-smoking advice, 28 percent.

Even though there are accepted standards for heart-attack treatment, elderly patients tend to have a variety of conditions that can complicate decisions about the best therapy, Ellerbeck said.

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