Reference: March 2026 | Issue 3 | Vol 12 | Page 55
The National Office of Clinical Audit (NOCA) has recently published the Irish Heart Attack Audit National Report 2024, which presents data on 1,615 patients who experienced a major ST-elevation myocardial infarction (STEMI).
The report was launched by Prof Ronan Margey, National Clinical Lead for the Irish Heart Attack Audit, at the NOCA Annual Conference 2026, which was held in February at the Royal College of Surgeons in Ireland (RCSI) as part of its Charter Week programme.
The conference was formally opened by Jennifer Murnane O’Connor TD, Minister of State for Public Health, Wellbeing, and the National Drugs Strategy.
The report offers an updated national overview of care for patients experiencing a STEMI. It highlights areas where care processes are performing well while also identifying opportunities to further strengthen the pathway. Primary percutaneous coronary intervention (PCI) remains the international gold-standard treatment for STEMI.
The audit shows that once patients arrive at a PCI centre, outcomes continue to align with international standards. It also emphasises that early recognition of symptoms, prompt diagnosis, and efficient transfer pathways are key factors in delivering timely care.
Key findings
- Early symptom recognition and appropriate action identified as key to faster treatment.
- A total of 45 per cent of patients called for help within an hour of symptom onset, a decrease from 49 per cent in 2023.
- Primary PCI was delivered to 77 per cent of eligible patients, a declining trend from 86 per cent in 2017.
- Only 61 per cent of patients received primary PCI within the recommended two hours after a STEMI is diagnosed.
- In patients who first present to a non-PCI capable hospital, only 3 per cent achieved the 30-minute door-in door-out (DIDO) target for transfer to a PCI centre.
- Around 55 per cent of those arriving directly by ambulance to a PCI centre achieved the 30-minute door-to-balloon target.
- Smoking remains a major risk factor and causes heart attack at much younger ages: 36 per cent of patients presenting with a heart attack were current smokers, and smokers experienced a heart attack on average 11 years earlier than non-smokers.
- 90 per cent of patients had at least one cardiovascular risk factor. The most prevalent risk factors were hypertension (53%) and hypercholesterolaemia (44%).
- 91 per cent of patients had an appropriate secondary prevention medication bundle prescribed, an increase from 86 per cent in 2023 and achieving the target of 90 per cent.
The audit makes four national recommendations, including optimising the use and timeliness of primary PCI by supporting hospitals to review local processes that influence early diagnosis and faster transfer times, and shortening door to balloon times.
Prof Margey said: “This year’s report highlights the need for a renewed focus on public awareness, system-level process improvement, and targeted risk factor management to reduce the incidence and improve the treatment of STEMI in Ireland.
“The system is most effective when every step – from recognising symptoms to calling for help, diagnosis, transfer, and treatment – happens without delay. The findings support hospitals, the National Heart Programme, the National Ambulance Service, and the wider system to target improvements where they will have the greatest impact.”
The report also highlights the vital role of patient and public engagement in shaping improvement. Paula Connor, a cardiac patient and member of the Irish Heart Attack Audit Governance Committee, shared her personal experience to raise awareness of how symptoms can present differently, particularly in women.
“I was only 44 when I had my heart attack, and I didn’t realise what was happening. I just felt faint and had pressure in my arms. I was lucky to get help quickly and receive life-saving treatment. My message is simple, don’t ignore unusual symptoms and call 112 or 999 straight away. Acting fast can save your life.”
