On average, patients treated during off-hours had the procedure done 88 minutes after arriving at the hospital. That compared with 77 minutes for patients treated during regular hours.

The hospitals in the study, Casella said, had experienced operators on duty round-the-clock, and had set up systems to get patients more quickly from their homes to the “cath lab” where angioplasty is performed.

While the hospitals were in Italy, Casella said there are recent studies from Europe and the U.S. showing similar results.

In general, patients with ST-segment heart attacks are being treated more quickly in recent years, notes Dr. Henry H. Ting in an editorial published with the study in the Journal of the American College of Cardiology: Cardiovascular Interventions.

Heart disease is the leading killer worldwide, with more than 1.2 million heart attacks annually in the U.S. alone.

A recent study of 831 U.S. hospitals found that in 2008, more than 75 percent of patients received a stent within 90 minutes of arriving at the hospital - the time that guidelines recommend. That was up from only half of patients in 2005.

And there’s evidence that off-hours patients are benefiting to a similar degree as patients treated during regular hours.

Ting, of the Mayo Clinic in Rochester, Minnesota, called the latest findings a “wonderful example” of what can be achieved when heart attacks are handled quickly at all times. But there’s still room for improvement, he points out.

In the current study, Ting notes, 16 percent of patients were not transferred to hospitals with intensive cardiac care units. And they had a “striking” death rate of between 25 percent and 35 percent.

It’s not clear why those patients were not transferred or what treatment they did receive, Ting writes. So an important issue, he says, will be how to further expand heart attack patients’ access to timely and adequate help.

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By Amy Norton

NEW YORK