CHICAGO (AP) _ Heart attack victims are dying because hospitals around the country aren't using simple treatments such as giving patients aspirin, researchers reported today.

``Nobody gets to decide where they're going to have their heart attack,'' said Gerald O'Connor, an epidemiologist with Dartmouth Medical School in New Hampshire. ``The real issue is the gap between knowledge and practice.''

O'Connor and his colleagues looked at the medical records of 186,000 Medicare patients treated for heart attacks in 1994 and 1995.

The results, reported in the Journal of the American Medical Association, showed substantial differences in the use of treatments recommended by the American College of Cardiology, American Heart Association and the consensus of experts.

For example, the most basic, low-tech recommended therapies are aspirin and beta-blockers. Beta blockers reduce the heart's workload; aspirin thins the blood.

Researchers used medical records to identify which patients were ideal candidates for certain treatments. They then determined what percentage of those patients actually got the treatment in 306 regions of the country.

Nationwide, 14 percent of patients for whom aspirin was appropriate did not get it, and 50 percent did not get beta-blockers.

Dr. David Meyerson, a cardiologist at Johns Hopkins University and spokesman for the American Heart Association, said the study offers important information. ``Patients or their families as health care consumers need to be their own advocates more than ever before,'' he said.

A study published last month in the New England Journal of Medicine had similar findings. The study by the Yale-New Haven Hospital Center for Outcomes Research and Evaluation found that heart attack patients fare best in top-rated U.S. hospitals _ not because those hospitals use expensive, state-of-the-art treatments but because they use beta blockers and aspirin.