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 NEW ORLEANS, Nov. 16 ~PRNewswire~ -- Heart attack patients who are women, live in the Northeast or arrive at the hospital at or around midnight are often not treated as quickly with thrombolytic (clot- dissolving) therapy as other heart attack victims in U.S. hospitals, according to findings from the largest national registry of heart attack patients.
 These and other emergency heart attack treatment trends from a cut of 75,000 patients from 600 hospitals enrolled in the National Registry of Myocardial Infarction (NRMI) were presented during the 65th annual scientific sessions of the American Heart Association (AHA).
 The Registry also found that patients treated with the thrombolytic therapy Activase (Alteplase, a recombinant tissue plasminogen activator) in Northeast~Mid-Atlantic states tend to receive fewer angiograms and angioplasties than those in other parts of the country.
 Since 1990, the National Registry of Myocardial Infarction (NRMI), sponsored by Genentech, Inc. (NYSE: GNE), has collected and analyzed information on how heart attack patients are treated. While not a controlled medical study, the NRMI reflects real-life treatment trends among heart attack patients. An ongoing service, the NRMI has enrolled more than 115,198 patients from 840 participating hospitals as of Nov. 1, 1992.
 Location in Hospital, Geographic Region Affects Treatment
 W. Douglas Weaver, M.D., director, cardiovascular critical care and professor at the University of Washington in Seattle and a member of the NRMI Advisory Committee, presented a comparative analysis focusing on time to thrombolytic treatment once NRMI patients had arrived at the hospital. Dr. Weaver compared time to thrombolysis in two subgroups: Between patients treated in two hospital departments -- the Cardiac Care Unit (CCU) versus the Emergency Department (ED) -- and between patients treated in various regions of the country.
 Those patients treated in the CCU waited significantly longer (50 percent) to receive thrombolytic therapy than those treated in the ED; an average of 75 versus 50 minutes, reported Dr. Weaver. He also observed regional differences in time to thrombolytic treatment, with patients in the Northeast waiting 24 percent longer in-hospital than patients in the West~Southwest (62 versus 50 minutes, respectively).
 "Our analysis shows that time from hospital admission to treatment with thrombolysis averaged one hour and has not consistently shown any meaningful improvement in the past two years," Dr. Weaver added. "It is vital that medical personnel monitor results in their hospital, and set goals to meet ACC~AHA guidelines calling for the elimination of treatment delays once patients have arrived at the hospital. In most cases, treatment should be initiated 30 minutes or less after hospital arrival."
 Additional factors were associated with delays in time to thrombolysis, regardless of where in the hospital or in which region of the country patients were treated, Dr. Weaver reported. These included being female, arriving at the hospital at or around midnight, and older age.
 Registry Reveals Practice Patterns for Adjunctive Therapy
 Trends in how frequently U.S. physicians in the four primary geographic regions -- Great Lakes~Midwest; West~Southwest; Northeast~Mid-Atlantic; South~Southeast -- use adjunctive therapy with Activase (Alteplase, a recombinant tissue plasminogen activator) was a focus of the second AHA presentation of NRMI data. The information was presented as a poster session by William J. Rogers, M.D., director, cardiac care unit and professor of medicine at the University of Alabama at Birmingham and an NRMI Advisory Committee member.
 Nearly all (98 percent) of the physicians enrolling patients in the NRMI administer intravenous (I.V.) heparin with t-PA. However, not as many routinely administer aspirin (approximately 81 percent overall), Dr. Rogers reported.
 In all regions, average physician use of coronary angiography and angioplasty for t-PA-treated patients was considered high (75 percent and 32 percent, respectively), Dr. Rogers said. However, there was a trend for physicians in the Northeast~Mid-Atlantic region to perform fewer such procedures (56 percent and 21 percent, respectively), compared to physicians overall.
 "Though numerous clinical studies have provided guidelines for use of adjunctive therapy with thrombolysis, scant data has been available on actual physician practice patterns," said Dr. Rogers. "The National Registry of Myocardial Infarction provides a feedback mechanism to enable physicians and hospitals to track their own heart attack practice protocols, compare the data to national trends, and identify areas for improvement."
 Physicians' average use of calcium channel blockers (43 percent) and I.V. nitroglycerine (75 percent) with t-PA was considered relatively high, while use of I.V. and oral beta blockers (15 percent and 31 percent, respectively) was relatively low, Dr. Rogers found. Frequency of use for these therapies was consistent between all geographic regions, he reported.
 The National Registry of Myocardial Infarction
 The National Registry of Myocardial Infarction, the largest registry of its kind, is sponsored by Genentech, Inc., but the data is analyzed independently of the company. The NRMI offers hospitals an opportunity to participate in a national cooperative project to evaluate heart attack management in the United States.
 -0- 11~16~92 R
 ~CONTACT: Jim Weiss, 504-529-7111 ext. 896 or (page) 504-553-1675 or at Genentech after Nov. 19: 415-225-2742 or Barri Solomon of Burson- Marsteller, 212-614-5143, for Genentech~

CO: Genentech, Inc. ST: Louisiana, California IN: MTC SU:

TS -- NY042 -- 1537 11~16~92 17:44 EST
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Date:Nov 16, 1992

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