MINNEAPOLIS - If you're having a heart attack, you may not need an emergency room at all, according to a groundbreaking study at United Hospital in St. Paul, Minn.

Researchers found that patients get faster care, and are more likely to survive, if an ambulance crew takes them straight to a specialized hospital "cath lab," where doctors can act quickly to open their blocked arteries.

Only a fraction of hospitals use this system, which relies on specially trained paramedics to diagnose heart attacks without the help of emergency-room staff.

But the study, led by Dr. Kenneth Baran, suggests that it can cut the time needed to treat the most dangerous heart attacks from an average of 81 minutes to 36 minutes, and vastly improve the chances of recovery.

"Our times were phenomenal," said Baran, a heart specialist at United Hospital. In fact, the average for those who arrived during daytime hours was just 22 minutes - "the lowest that's been recorded," Baran said.

Baran's team also found that the patients who went straight to the catheter lab were less likely to die in the hospital (3.9 percent) than those who came through emergency (7.5 percent).

Experts say that the minutes after a heart attack are crucial because muscle starts to die when oxygen is cut off. If the blockage can be cleared within 60 minutes or so, experts say, the heart attack may cause little permanent damage.

"I think it's quite inspirational," said Dr. Henry Ting, who heads a similar program at the Mayo Clinic in Rochester. The study "shows what is possible with focus and creativity."

The "gold standard" for hospitals is to treat a heart attack patient within 90 minutes of arrival.

"Thirty to 40 minutes, that's a major achievement," Ting said.

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