Lot many patients with severe heart disease who routinely undergo invasive stenting or surgical procedures to open up blocked arteries would do as well by just taking medications and making lifestyle changes, U.S. researchers reported on Saturday.
If the study gets adopted into practice, the findings could save hundreds of millions of dollars a year in healthcare costs, researchers said.
The $100 million government-backed study, presented at the American Heart Association (AHA) meeting in Philadelphia, is the largest yet to look at whether procedures to restore normal blood flow in patients with stable heart disease offers an added benefit over drug 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. Stents are tiny tubes that keep the artery open after blockage-clearing angioplasty.
At least two prior studies have determined the same findings suggesting 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.
These studies emphasize the role of drugs in Stable angina, not in unstable angina.
Many cardiologists will be reluctant to change practice in part because patients who get stents to keep the artery open report feeling better right away, experts said.
“There’s always been a fear that if you don’t do something quickly, they will have a heart attack or drop dead,” cardiologist Dr Hochman said.
In rare or mild chest pain patients, 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.
Just eliminating unnecessary stenting procedures could save Billions of dollars across the world, and lot much to the people at individual level.
Cleveland Clinic cardiologist Dr. Steven Nissen was convinced. “We can reserve these interventions for people who truly fail medical therapy,” he said.
Experts said the study was well done, and its findings will be hard to ignore. But it may take several years for the changes to filter into practice.
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