Propping open clogged arteries with a tiny wire mesh tube called a stent is no better at reducing the risk of heart attack or death in patients with stable heart disease than treatment with medications, according to a large new study that challenges routine use of a procedure that rapidly became standard medical practice.
The researchers and others stressed that angioplasty clearly benefits patients who are in the throes of a heart attack or are at very high risk for one. But the findings indicate that for a patient whose condition is stable, medical therapy is just as effective at reducing the major risks. Such patients constitute at least one-third of those undergoing the 1.2 million angioplasties performed each year, and perhaps as much as 85 percent.
I’ll be interested to see if Americans switch from surgery to medicine. I wonder if we’ll see doctors continue to recommend surgery for male patients, while offering medicine to female patients. It hasn’t worked with circumcision and UTIs, so why should it be any different with heart surgery. That’s more important. Are we willing to trust aspirin on our fathers when we can’t trust antibiotics on our sons?
The findings underscore the danger of rushing to adopt a procedure before careful studies have been conducted to fully determine its benefits, Boden and others said.
“There was just this intuitive belief that it would be beneficial,” Boden said. “But no one had ever done a proper randomized trial to see whether it actually improved outcomes. In the meantime, a whole industry has been created around this.”
… this intuitive belief that it would be beneficial. It’s hard to believe that’s not enough. Hard to believe, indeed.