A new large federal study found that drug therapy can save lives as effectively as bypass surgery or stents.
During the annual meeting of the American Heart Association over the weekend, scientists reported the findings of a large federal study on bypass surgeries and stents call into question the medical care provided to tens of thousands of heart disease patients with blocked coronary arteries.
According to The New York Times, the new study found that patients who received drug therapy alone did not experience more heart attacks or die more often than those who also received bypass surgery or stents, tiny wire cages used to open narrowed arteries.
That finding held true for patients with several severely blocked coronary arteries. Stenting and bypass procedures, however, did help some patients with intractable chest pain, called angina.
Dr. Alice Jacobs, director of Cath Lab and Interventional Cardiology at Boston University, said: "You would think that if you fix the blockage the patient will feel better or do better. The study certainly will challenge our clinical thinking."
This is far from the first study to suggest that stents and bypass are overused. But previous results have not deterred doctors, who have called earlier research on the subject inconclusive and the design of the trials flawed.
Previous studies did not adequately control for risk factors, like LDL cholesterol, that might have affected outcomes, said Dr. Elliott Antman, a senior physician at Brigham and Women's Hospital in Boston. Nor did those trials include today's improved stents, which secrete drugs intended to prevent opened arteries from closing again.
The new study, called Ischemia, was intended to settle questions about the benefits of stents and bypass. The results will be incorporated into treatment guidelines, said Dr. Glenn Levine, who sits on the guidelines committee of the American Heart Association.
