February 21, 2018

Heart Stents Not Likely to Relieve Chest Pain

06 November 2017, 05:07 | Rodolfo Wallace

A study by Imperial College London found the operation has a huge risk of damaging the arteries but does not improve quality of life

A study by Imperial College London found the operation has a huge risk of damaging the arteries but does not improve quality of life

Typically used to unblock an artery and maintain vascular patency and dilation, stenting is also done for patients whose arteries aren't blocked, but experience angina caused by exertion because of narrow arteries - often referred to as stable angina.

Also, most of the time, doctors insert stents to those who suffer from acute chest pain, as the devices might relieve their ailment. The researchers who conducted the study say that they need to further analyze the data to see if there may be subgroups of stable angina patients who do benefit from the stenting procedure.

The devices are lifesaving when used to open arteries in patients in the throes of a heart attack.

More frequently, however, stents are implanted in patients with blocked arteries who experience chest pain, a condition called angina. This could mean that medications alone could be enough to treat certain kinds of patients, instead of the more expensive stent that opens arteries.

Patients who received stents did not have more improvements in angina or quality of life than those who did not receive a stent.

Inserting a stent costs between $11,000 and $41,000, the Times said.

The study was published online November 2 in The Lancet medical journal, to coincide with a presentation at a cardiology meeting in Denver.

Al-Lamee said, "Surprisingly, even though the stents improved blood supply, they didn't provide more relief of symptoms compared to drug treatments, at least in this patient group".

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"While these findings are interesting and deserve more attention, they do not mean that patients should never undergo the [stent] procedure for stable angina".

Following the procedure, both groups of patients then took powerful drugs to prevent blood clots.

"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.

"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".

But now, a study published this month in the medical journal Lancet is casting doubt on the practice, suggesting that stents are useless for the majority of these patients.

Writing in a commentary that accompanied the report, two cardiologists said the "landmark" study has implications that "are profound and far-reaching".

Dr Brown, a cardiologist, said stenting remains a "crucial treatment", particularly among patients intolerant to medication or medical therapy. The NYT reported about half, or 1,200 of the cardiac catheterizations performed at Lawnwood (the Florida hospital) were determined to have been done on patients without significant heart disease.

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