The research — published in The Lancet, one of the world’s most prestigious medical journals — also shows that most of the Indians simply cannot reach the hospitals in time.

The average time taken to reach hospitals was longer in India (about 300 minutes) than in developed countries (140-170 minutes), Dr Denis Xavier from St Johns Medical College and lead author of the study told Deccan Herald.

Canada’s McMaster University was also a collaborator. Dr Xavier and Dr Prem Pais from the St Johns hospital were the two leading researchers involved in the study.

Critical delay

The reason for such critical delays includes use of public or private vehicles rather than ambulance and lack of awareness of symptoms. Unfortunately for heart attack patients, the golden window of opportunity fades with elapsing of time.

The research involves 20,468 heart patients recruited at 89 centres in 50 cities spanning over 14 states including Karnataka which had three centres in Bangalore, Gulbarga and Shimoga. The data was collected till the end of 2005.

Ischemic heart disease is the leading cause of death globally. In 2001, the disease accounted for 7.1 million deaths worldwide, 80 per cent of which were in low-income countries. But to a large extent the threat can be minimised by suitable changes in lifestyle and diet, he said.

Between 1990 and 2020, ischemic heart diseases are expected to increase by 137 and 120 per cent for men and women in developing countries, compared with 30-60 per cent in developed countries.

Restricted treatment

“We found that patients with acute coronary syndromes in India tend to be 10 years young and from lower socio-economic groups. Because the poor are less likely to get evidence-based treatments, they have higher mortality within 30 days than others,” Dr Xavier said.

Since most of patients pay from their pockets instead of depending on insurance companies or the government, the choice of payment restricts the treatment option. This complicates the situation further.

Many patients opt for thrombolytic treatment using drugs like streptokinase, in which clots inside a blood vessel are broken down using medicines. They prefer to stay away from the better but costlier option of balloon angioplasty. “An angioplasty costs about Rs one lakh whereas streptokinase treatment costs about Rs 3,000 for one injection. With cost being a major factor, we look into the cost-benefit factors before deciding on treatment options,” Dr Xavier said.

Desi food

Tendency to eat fried food like vada and samosa, excessive smoking and rapid urbanisation leading to reduction of physical activities are contributing to spurring growth in heart disease. Similar trend has been observed by other nine hospitals who were partners in the project. 

Meanwhile, recently, it was reported in the US that artificial blood substitutes being tested on humans have significantly raised the risks of heart attack and death.