According to recent studies, heart stents are being overused, causing unnecessary complications.
When a patient has heart trouble, I believe one of the worst fears would be open heart surgery. And, although many don’t ever get to that point, there are some patients that need help keeping their arteries open therefore requiring a nonsurgical procedure, where a stent is placed.
But, what if your doctor recommended a stent, and in all actuality you didn’t really need it? Wouldn’t you want to avoid it if unnecessary?
I believe most would answer “yes.” And, apparently, a new study claims that most patients don’t need it, and medication could simply be the answer.
The study has found that heart stents may be overused in the United States, specifically on patients diagnosed with stable heart disease. Actually, according to the new research, as many as two out of three may not be needed.
The analysis of eight large clinical trials found that the addition of opening narrowed arteries with stents provided no added benefit over aggressive therapy with medication alone as a first treatment for patients with stable disease.
Stents are small mesh tubes that are often inserted during angioplasty to prop open blood vessels and help them stay unblocked. Angioplasty is a nonsurgical procedure that uses a small balloon to open up a blocked artery.
Compared to medication alone, stenting — plus medication — did not result in fewer deaths, non-fatal heart attacks, or emergency bypass procedures; or improvements in symptoms such as chest pain over four years of follow-up.
Researcher David L. Brown, M.D., of Stony Brook University Medical Center in New York, stated far too many stent procedures are performed in the United States each year in patients who have not first been offered medication to manage heart attack and stroke risk factors.
“In our analysis, a third of patients ended up needing stents because medical management was not effective for relieving symptoms, but two-thirds did not need them,” Brown told WebMD.
Although there are known benefits to opening newly blocked arteries during heart attack, many studies have found little benefit for performing angioplasty with or without stents when not in an emergency situation, according to WebMD.
Over 400,000 nonemergency coronary stenting procedures are performed annually in the U.S., according to the American Heart Association (AHA).
Should two-thirds be avoided, there would be a huge correlative savings in health dollars, noted Brown.
One estimate found that a reduction of elective stent procedures by just one-third would provide $6 to $8 billion in annual savings to the U.S. health system according to WebMD.
The AHA and the American College of Cardiology (ACC) recommend aggressive medication treatment as the initial therapy for stable angina, also known as heart-related chest pain with exertion, or asymptomatic narrowed arteries, WebMD explained. A recent study revealed that over half of these patients underwent angioplasty and stent implantation before drug treatment.
The new analysis appears in the journal Archives of Internal Medicine and involved a review of 7,229 patients treated for stable heart disease between 1997 and 2005. About half received medicated stents; the remainder received medication alone.
The study said up to 76 percent of stable heart disease patients who are first treated with medications could avoid angioplasty and stenting, leading to savings of about $9500 per patient according to WebMD.
“As more and more studies show that medicine works well and is cheaper and less risky than these interventions, I think practitioners — even interventional cardiologists — will be adopting this strategy more and more,” AHA President Gordon Tomaselli, M.D., told WebMD. Tomaselli also directs the cardiology division at Johns Hop