Stents May Be Unnecessary For Certain Heart Patients, Study Says

Stents can save lives by propping open clogged arteries in heart disease patients, but a new study suggests stents may do nothing to relieve another common heart problem -- chest pain.

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.

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.

The research, published this week in the Lancet medical journal, studied 200 patients who had a blocked coronary artery and were experiencing chest pain.

Everyone was wheeled into the operating room and underwent a procedure.

Around two million people in the United Kingdom and 10 million in the USA have angina, which causes chest pain following physical activity because of restricted blood flow to the heart.

The patients were tested on a treadmill to see how long they could exercise and then were put on medication to increase blood flow and prevent a heart attack. It is typically caused by the build-up of fatty plaques in the arteries.

Stents and their implantation cost from $11,000 to $41,000 in American hospitals.

The study was published online November 2 in The Lancet medical journal, to coincide with a presentation at a cardiology meeting in Denver. Six weeks later, there was no real difference in chest pain between the groups.

"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.

'It may be that some patients opt to have an invasive procedure over taking long-term medication to control their symptoms'. Stents should be relieving chest pain for those who suffer from angina, but the results show they might not actually be that necessary.

In fact, these cardiologists are calling for a downgrade in stent recommendations, citing the fact that over half a million patients in the USA and Europe undergo stent treatment, and that a significant minority go through severe complications like heart attacks, stroke, kidney failure and even death.

That said, the study can not be taken as conclusive or definitive at this point.

Researchers said the results appear to contradict what patients experience after receiving a stent for angina. They add that subjecting such patients to stenting when no benefit can be achieved is irresponsible.

"I think this is a game-changer", Dr. Rita Redberg, a researcher and cardiologist at the University of California, San Francisco, told the Minneapolis Star Tribune, "I think we have some real explaining to do".

Doctors need to focus more on drug therapy and efforts at "improving the lifestyle choices" of many heart patients - things like bad diets, lack of exercise and smoking, the editorialists concluded.

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