Angioplasty May Not Boost Survival for Some Heart Disease Patients

Angioplasty Survival for Heart Disease Patients

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — Angioplasty — the procedure used to open narrowed or blocked arteries — doesn’t seem to lengthen life for people with stable heart disease and chest pain, a new study finds.

After 15 years of follow-up, the study found that people who had angioplasty fared no better than those who had their heart disease treated with medication and lifestyle changes alone.

“[Angioplasty and] stenting is effective and improves survival when performed early in the course of a heart attack,” said lead researcher Dr. Steven Sedlis, an associate professor of medicine at NYU Medical School in New York City. “But the benefits of routine [angioplasty and] stenting for patients with stable heart disease have been uncertain and highly controversial.”

During the angioplasty procedure, a small tube may be placed in the blood vessel to keep it open. This is called stenting.

Routine angioplasty and stenting don’t improve long-term survival, and this study supports current guidelines that recommend medications first, Sedlis said. Angioplasty and stenting should be reserved for patients whose symptoms cannot be controlled by medications, he explained.

Co-author Dr. William Boden, a professor of medicine at Albany Medical College in Albany, N.Y., said, “We know that in heart attack patients, angioplasty can be lifesaving.”

But in patients with stable heart disease — even those with chest pain — medication and lifestyle changes (or “medical therapy”) may be the best way to minimize the risk of heart attacks and heart-related death, he said.

Boden explained that medical therapy includes drugs to lower blood pressure and cholesterol, and aspirin to reduce the risk of blood clots. In addition, patients may receive lifestyle counseling to help them quit smoking, and improve their weight through exercise and eating a healthy diet.

About one million angioplasties are done each year in the United States, and about 500,000 are done in patients with stable heart disease, Boden said.

Stable heart disease refers to chest pain that occurs in a predictable pattern, such as when you’ve been exercising for a certain period of time. Stable heart disease is usually relieved by rest or with medication, the American Heart Association (AHA) says. Unstable heart disease is unpredictable or surprising chest pain. It usually occurs when you’re resting. Unstable chest pain often leads to a heart attack, according to the AHA.

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