Supported by Heart Research Australia, two internationally recognised pilot studies have:
- cut heart-attack mortality rates at Sydney's Royal North Shore Hospital from 30% to a world-beating 2%
- reduced the time-lapse from onset of symptoms to surgery by more than 100 minutes.
Cardiologists Dr Gregory Nelson and Professor Helge Rasmussen developed the program, which sees some patients returning to work within three days. Results of the studies have now been published in the European Heart Journal, the official publication of the European Society of Cardiology.
On this page: Setting new standards · Case study: minute by minute
Study 1: Faster unblocking of arteries
Using stents rather than drugs, this treatment (known as SALAMI) reduced heart-attack mortality rates at Royal North Shore from 30% to 8%.
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Study 2: Faster assessment

Patients are assessed in the ambulance. This follow-up program (known as ETAMI) has achieved even better results. Mortality rates have fallen further – from 8% to 2%.
Learn more
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‘Anywhere else, these ideas might have stayed in someone's notebook. But thanks to the support of Heart Research Australia, the study could be trialled, perfected, and now, given international recognition.' – Dr Gregory Nelson, Director of Interventional Cardiology, Royal North Shore Hospital |
Setting new standards
- The time-lapse from onset of chest pains to inserting a stent has dropped from 240 minutes to 125 minutes.
- Average hospital stays have reduced from 7.2 days to 3.2 days.
- The potential for heart scarring has been markedly reduced. Researchers believe that is why fewer patients are dying.
Case study: minute by minute |
| Sunday morning |
| 9.00 |
A 56-year-old man develops chest pain |
| 9.17 | He calls an ambulance when pain doesn't stop |
| 9.28 | Ambulance arrives at Ryde, Sydney |
| 9.34 | Paramedics take an ECG |
| ECG sent to RNSH* emergency | |
| Heart attack diagnosed | |
| Cardiac team alerted and head for hospital | |
| 9.54 | Patient arrives at hospital |
| 10.20 | Artery unblocked, stent inserted |
| Heart shows minimal damage |
| 3 days later: Patient goes home, and soon returns to work |
| Treatment time: 80 minutes from onset to surgery |
| *Royal North Shore Hospital. If he had gone to the nearest hospital, treatment would have been greatly delayed. |






