50,000 Unnecessary Heart Procedures

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50,000 Unnecessary Heart Procedures

JoAnn Guest

Apr 20, 2007 13:50 PDT

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50,000 Unnecessary Heart Procedures

Matthew Herper, 11.14.06, 12:00 PM ET

 

 

CHICAGO - Some 50,000 procedures done every year to open patients'

arteries after a heart attack are unnecessary and possibly harmful,

according to a large study.

 

The 2,166-patient study found no benefit to the procedure, called

angioplasty, when it was performed more than three days after the

patient had a heart attack. Angioplasty, in which a balloon is used

to

open a clogged artery and a metal mesh tube called a stent is then

used

to hold the blood vessel open, has been shown to be lifesaving when

performed right after a heart attack, and doctors are making a big

push

to make sure that patients get the treatment then.

 

But the new study, presented here at the American Heart Association

and

published online in The New England Journal of Medicine, looks at

patients whose heart disease had become stable, putting them at

somewhat

lower risk for a repeat heart attack.

 

All patients received the best drug therapy available, but only half

received angioplasty and a stent. There was no statistically

significant

difference between the two groups, but there was a trend showing an

increase in heart attacks among the people who received the stent

after

four years.

 

Judith Hochman of the New York University School of Medicine, says

that

trials that had evaluated the idea of opening the artery had been

small

and had presented conflicting results.

 

However, she said, many doctors refused to participate in the study

because they considered it unethical to refuse patients angioplasty.

That slowed down the trial, and it took five years to get enough

patients enrolled to finish the study. " There was good evidence, "

says Hochman. " It was not randomized data. "

 

Companies that make stents include Boston Scientific (nyse: BSX -

news -

people ), Medtronic (nyse: MDT - news - people ) and Johnson &

Johnson

(nyse: JNJ - news - people ). There has recently been controversy

about

the newer, drug-coated variety. This study does not directly impact

on

that debate. However, it may have an effect on the larger argument

among

doctors over whether angioplasty, which is performed a million times

a

year, is overused.

 

In an editorial in The New England Journal of Medicine, David Hillis

of

the University of Texas, Southwestern, and Richard Lange of Johns

Hopkins write that there may still be a few people of the type

included

in the study who would benefit, but agree that most of these

patients--100,000 a year, according to Hochman--should receive

medical

therapy. Until now, half of them would have gotten angioplasty or a

stent.

 

http://www.forbes.com/business/2006/11/14/cardiology-stents-

procedures-biz-cz_mh_1114stents.html

 

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest