Heart attack patients discharged from the hospital have a 46 percent increased chance of dying within a month if they fail to fulfill even one of the nine recommended types of care, according to new research from the University of Leeds.

After one year of hospital discharge, heart attack patients have a 74 percent chance of death if one step of care is missed.

The nine steps of care after a heart attack include pre-hospital electrocardiogram, acute consumption of aspirin, reestablishing blood flow to the heart, prescription of aspirin at the hospital, using one of four types of heart attack drugs, and cardiac rehabilitation referral following hospital discharge.

Lead researcher Dr. Chris Gale, of the School of Medicine at the University of Leeds, and colleagues analyzed approximately half of about 31,000 heart attack patients discharged from hospital in the UK between 2007 and 2010 who missed one of the nine courses of treatment.

They found that even one missed step led to a dramatic increase in the risk of death following a heart attack.

“It is vitally important that healthcare professionals working in the heart disease field are made fully aware of, and trained in, these nine types of treatment so that the chances of saving a heart attack patient’s life are maximized. Many of these guideline recommended steps are straightforward, but for some reason they are not being provided. If more components of care are missed, the chance of dying increases further,” said Gale in a statement.

The findings of the study are published in European Heart Journal Acute Cardiovascular Care.