By Ed Susman, Special to CBS HealthWatch

Aug. 29 (CBSHealthWatch)--A double-dose of surgery plus drug therapy may be just what a heart attack victim needs to prevent a repeat performance and improve chances of survival, according to a large new Scandinavian study.

Experts say taking home a prescription for cholesterol-lowering drugs gives a heart attack survivor a 34 percent lower risk of dying within the subsequent 12 months. And if that patient undergoes a surgical procedure to improve blood flow to the heart within two weeks after the heart attack, he or she cuts the risk of dying in half. But researchers from Sweden, who scrutinized the detailed records of nearly 23,000 people, say that if that heart attack victim gets both the prescription and surgery, the risk of death within the year drops by 64 percent.

Although both the prescription drugs known as statins and the "revascularization" operations are known to be lifesavers, researchers say the chance of receiving the treatments varies greatly and may depend upon where you live.

"This is the first demonstration of the advantages if starting cholesterol lowering treatment already before discharge," says Dr. Lars Wallentin, professor of cardiology at University Hospital in Uppsala, Sweden. "This is also the first evidence that early surgical procedure reduces mortality in the real life situation."

Dr. Ulf Stenestrand, a cardiologist at University Hospital in Linkoping, Sweden, told the 22nd congress of the European Society of Cardiology that only 7% of heart attack survivors in some hospitals included in the nationwide survey left the facility with a prescription for a statin. That's despite the fact that Scandinavia was the site of a massive clinical trial in 1994 that proved the drug simvastatin could reduce the risk of a second heart attack.

In contrast at other hospitals in Sweden nearly 60 percent of patients walked out with a prescription for the drug. Just because a patient gets the prescription, doesn't mean he will take the medication, says Wallentin. But, he adds, "We believe that if you start the patient on a statin, the patient will continue on the drug."

Stenestrand says his figures also show that in just eight of the 73 hospitals do more than 10% of the patients receive "revascularization"--either open heart bypass surgery or angioplasty, although 90% of the clinics in Sweden have an intensive care cardiac unit.

The study provided a 14-day window for performing early surgery or angioplasty, Wallentin says, because some smaller hospitals don't have facilities to do the procedures and need time to stabilize the patient and transport him to another hospital for the procedure.

In open heart bypass surgery, a major operation that often requires several days in the hospital, a vein or artery is harvested from a patients leg; the chest is opened, the heart is stopped and the harvested blood vessels are sewn in place "bypassing" blockages in blood vessels servicing the heart. These blockages can cause heart attacks.

Angioplasty is a less invasive procedure. An incision is made in the leg and a catheter is inserted into a major blood vessel. Through x-ray guidance the catheter -- equipped with a balloon tip -- is positioned next to blockages in the heart arteries. When the balloon is inflated, the blockage is crushed to the side of the artery wall, allowing for blood to pass more easily. Both procedures require clinical expertise and specialized equipment.

Dr. Klas Malmberg, associate professor of cardiology at the Karolinska Institute, Sweden, says, "The study is not randomized, but it certainly had large numbers of people. There are studies that are ongoing that are attempting to find the same answers. Even so, the results seem quite impressive."

　　(From AOL.com)