Central Alberta heart attack patients up to 70% more likely to die, doctors warn

Red Deer doctors are pleading for help, saying people in central Alberta are dying needlessly because they don't have timely access to life-saving procedures.

An Alberta Health Services (AHS) document written in December 2014 — and recently obtained by CBC News — examined the need for more cardiac services in central Alberta.

It reveals people in that part of the province had a 70 per cent higher death rate after a heart attack than people in Calgary between 2007 and 2010.

A more recent AHS performance report shows that as recently as last year (2014-15), heart attack patients in central Alberta had a 47 per cent higher mortality rate than people in Calgary.

The year before, the difference was 41 per cent. In 2012-13, it was 14 per cent, according to AHS.

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Having lab in Red Deer could save 32 people a year, doctor estimates

Most heart attack patients in central Alberta must be taken to Alberta's two major cities because standard, time-sensitive treatments such as angioplasty can't be done in that part of the province.

"It's extremely concerning," said Red Deer cardiologist Dr. Gustavo Nogareda. "It's so frustrating when we see that we cannot deliver standard of care to our patients."

The quality of the treatment you receive after a heart attack depends on where you live.

Most heart attack patients in central Alberta are offered clot-busting IV drugs before being transferred out by ground ambulance or STARS air ambulance.

Those drugs, known as thromoblytics, are not the go-to treatment in major centres, where virtually all patients are immediately treated with cardiac catheterization, a procedure in which doctors insert a long tube into an artery and can use a tiny balloon to eliminate blockages.

"No matter how you slice it, thrombolysis is inferior to having treatment [for a heart attack] at a cardiac catheterization lab," said Dr. Kym Jim, head of Internal Medicine at Red Deer Regional Hospital.

For years, Jim, Nogareda, and others have been calling on Alberta Health Services and the health minister to support the creation of a cardiac catheterization lab at Red Deer Regional Hospital so patients have immediate access to life-saving treatments.

"The very frustrating thing about all of it, is that it is a service that is readily available. It would be safe to be done here in Red Deer," said Jim.

Having a cardiac catheterization lab in the Red Deer hospital would save roughly 32 lives every year, according to Jim.

"[That] is significant, particularly if it's your loved one, your family member, someone that you know," said Jim.

Advocates call for change

The situation is considered so desperate, a local fundraising organization has taken on an advocacy role, earmarking $10 million in donations for startup costs.

"We're demanding we get the same services you have in Calgary or Edmonton," said Robert Bilton, chair of the Red Deer Regional Hospital Foundation. "As a matter of fact, you're actually taking a risk coming to the central region."

Three years ago, one of Bilton's employees, a welder, suddenly had a heart attack.

Once the man arrived at the hospital in Red Deer, Bilton received a phone call from doctors. "They ... said, find this man's family, he's going to die," said Bilton.

"By the time they would have transferred him to Edmonton or Calgary, the damage would have been so severe, there's no chance that he would survive. "

The man's wife and children made it to the hospital just in time to say good-bye.

"This is the type of thing that's happening in central Alberta and it's unacceptable. And we're just not going to take it anymore," said Bilton.

AHS working on business plan

AHS says it has worked to improve heart attack mortality rates in central Alberta with some success. But officials admit there is more work to be done.

"Looking at the information and the data, I think we agree that there is a need to prioritize this kind of work," said Kerry Bales, chief zone officer with AHS.

Bales says officials are starting to put together a business plan to address the cardiac needs for the area and are considering options for a cardiac catheterization lab. The plan will be included in next year's capital submissions to the province.

But Bales believes a lot of factors could contribute to the higher heart attack death rates, including higher rates of tobacco use in some rural areas.

"The solutions to improve cardiac mortality are beyond just looking at some capital developments that could occur," said Bales.

Doctors blame lack of political will

AHS's own report states the reasons for the higher mortality rates in central Alberta are "likely multifactorial but access to the most definitive therapy [for heart attacks]...as well as the scarcity of sub-specialty trained cardiologists could easily be hypothesized to be major contributors."

The document, now nearly two years old, outlined the need for advanced cardiac care in Red Deer within three to five years.

"We are very disappointed," said Nogareda, who is frustrated there is still no firm commitment from health officials.

"We came [to them] with the highlight of a major gap in care, and with a solution to address that problem ... When you look at the facts ... I think the most rational explanation is that there is no political will."

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