What is SMHeartCard?
SMHeartCard is designed to save the lives of your patients at risk of heart attack. This credit card sized pill holder stores four ASA 81mg tablets and three NitroStat 0.3 mg pills, which are the recommended emergency medications given for the initial treatment of heart attack and angina (1). SMHeartCard encloses nitroglycerin in a patented, chemically inert container that keeps the pills stable for six months across a wide range of conditions (2,3). SMHeartCard is designed to keep in a wallet, pocket, or purse, so it is immediately available; your patient only has to follow the written instructions on the card to improve their chances of surviving a heart attack. We have a 90 second explainer video here.
SMHeartCard was developed with the University of Alberta and Mazankowski Heart Institute, and validated at the University of Alberta Faculty of Pharmacy and Pharmaceutical Sciences (2,3).
Which patients should I consider for SMHeartCard?
Your patients at risk of coronary artery disease should carry SMHeartCard. Only 20% of Canadians with known coronary artery disease actually carry their prescribed nitroglycerin on them, and virtually none carry ASA (4). Your patients with any risk factors for coronary artery disease, including diabetes, hypertension, hyperlipidemia, sedentary lifestyle, obesity, family history of CAD, age > 50 can benefit from immediate treatment of suspected myocardial infarction: Canadians with heart attacks average more than 90 minutes delay to receive ASA and nitroglycerin after they get to the emergency room (5), and approximately 30% of people don’t survive long enough to get to a hospital with their first heart attack (6).
Whom should I not consider for SMHeartCard?
Patients with allergies to ASA should not receive SMHeartCard. Non-clinically significant hypotension occurs in 0.7-3 % of people given pre-hospital nitroglycerin (7). Nitroglycerin should not be taken within 24 hours of taking Viagra (sildenafil), or 48 hours of Cialis (tadalafil) or Levitra (vardenafil).
I’m happy to answer any questions you may have,
John Mackey, MD FRCPC FCAHS
Medical Director, SMHeartCard Inc.
- O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Jr., Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(4):e78-e140.
- Le T, Paterson DI, Davies N, Mackey JR. Development and validation of a compact on-person storage device (SMHeartCard) for emergency access to acetylsalicylic acid and nitroglycerin. Canadian Medical Association Journal, in press, 2020.
- Le T, Paterson DI, Davies N, Mackey JR. Improving compliance and access to nitroglycerin and aspirin in people with coronary artery disease: development and validation of the SMHeartCard system. Canadian Cardiovascular Congress, 2018.
- Horsman C, Frederick T. Poor Compliance With Carrying Nitroglycerin and Aspirin in Patients With Coronary Artery Disease. Can J Cardiol. 2018;34(7):945 e1.
- Dufresne F, Blouin D, Xue X, Afilalo M. Underutilization of acetylsalicylic acid for acute coronary syndromes in the emergency department. CJEM. 2004;6(5):333-6.
- Dudas K, Lappas G, Stewart S, Rosengren A. Trends in out-of-hospital deaths due to coronary heart disease in Sweden (1991 to 2006). Circulation. 2011;123(1):46-52.
- Clemency BM, Thompson JJ, Tundo GN, Lindstrom HA. Prehospital high-dose sublingual nitroglycerin rarely causes hypotension. Prehosp Disaster Med. 2013;28(5):477-81.