Stents May Be Unnecessary For Certain Heart Patients, Study Says

Faith Castro
November 6, 2017

New research suggests a popular treatment for chest pain may be useless for many people, The New York Times reported today.

Kindsvater says questions are being raised since the study only looked at 200 patients with stable angina, that's chest pain or chest heaviness.

Cardiologists said one reason for the results of the study might be that atherosclerosis (the blocking of the arteries) affects many blood vessels, and stenting only the largest blockage may not make much difference in a patient's discomfort.

Moreover, angioplasty is an expensive and sometimes elective procedure, which means patients could end up paying up to $50,000 in certain states across the U.S.

A stent is a small tube used to open up arteries in patients experiencing heart attacks, or chest pain due to blocked arteries. Each of them received six weeks of intensive drug therapy for their condition, after which they were divided into two groups.

Patients who received stents did not have more improvements in angina or quality of life than those who did not receive a stent. Angina is the medical term for chest pain, which is usually caused when fatty plaques build up in the arteries.

During the study, carried out by Imperial College London cardiologist Dr Justin E Davies and his colleagues, a stent was inserted into half of the patients and a placebo operation, without inserting a stent, was performed on the other patients.

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The study was published online November 2 in The Lancet medical journal, to coincide with a presentation at a cardiology meeting in Denver.

One finding was that the stents did improve blood supply but did not relieve symptoms in a more enhanced way when compared to drug therapy.

"It seems that the link between opening a narrowing coronary artery and improving symptoms is not as simple as everyone had hoped", Al-Lamee said. The sample group consisted of patients with stable angina.

"All cardiology guidelines should be revised", Dr. David L. Brown of Washington University School of Medicine and Dr. Rita F. Redberg of the University of California, San Francisco, wrote in an editorial published with the new study, according to the Times.

Dr Brown, a cardiologist, said stenting remains a "crucial treatment", particularly among patients intolerant to medication or medical therapy. They add that subjecting such patients to stenting when no benefit can be achieved is irresponsible.

Kindsvater says more often than not, stents are absolutely needed.

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