Stents no better than drugs for many heart patients
Cardiology patients with with mild or no chest pain would do as well by just taking medications and making lifestyle changes and there’s really not a role for immediately stenting, a new US study claims.
The $100 million government-backed study was presented at the American Heart Association (AHA) meeting in Philadelphia, Reuters reports.
It is the largest study yet to look at whether procedures to restore normal blood flow in patients with stable heart disease offer an added benefit over more conservative treatment with aspirin, cholesterol-lowering drugs and other measures.
Current guidelines recommend patients with severe narrowing of their arteries have heart bypass surgery or a stent implanted to restore blood flow.
Many cardiologists are reluctant to change practice in part because patients who get stents to keep the artery open report feeling better right away, experts said.
But at least two prior studies determined that artery-clearing and stenting or bypass surgery in addition to medical treatment does not significantly lower the risk of heart attacks or death compared with non-invasive medical approaches alone.
Eliminating unnecessary stenting procedures
The main goal of the trial was an overall reduction in deaths, heart attacks, hospitalization for unstable chest pain or heart failure and resuscitation after cardiac arrest.
On these measures, the addition of stenting or bypass surgery to reroute blood flow around the arterial blockage was no better at reducing the adverse events than medical therapy alone. The invasive treatments did result in better symptom relief and quality of life in those who had frequent chest pain.
Saving $570 million annually
Just eliminating unnecessary stenting procedures could save the U.S. healthcare system $570 million annually, said Stanford University School of Medicine cardiologist and study co-chair Dr. David Maron. He estimates the cost per stenting procedure at about $25,000 and bypass surgery at $45,000.