Monday, November 23, 2015

Heart Stints Ineffective?

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.

“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 stenting for patients with stable heart disease have been uncertain and highly controversial.”

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 may be the best way to minimize the risk of heart attacks and heart-related death, he said.

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.

“Patients need to understand what they are getting an angioplasty for,” Boden said. “If they are being told that it’s going to reduce the risk of heart attack or it’s going to make them live longer, they’re getting the wrong message.”

Dr. Gregg Fonarrow, a spokesman for the American Heart Association explained that “while angioplasty of patients with stable heart disease has often been perceived by patients and their doctors to reduce the risk of heart attacks and death, clinical trials have shown no such benefit compared with medical therapy alone.”

My Take:
In summary, 50% of the angioplasties performed each year in the U.S. are unnecessary. That’s a half million surgical procedures. Finally, the American Heart Association is speaking out on this topic. However, don’t hold your breath waiting for these unwarranted surgeries to stop. Physicians will continue to scare patients into having surgery.

The key to making heart disease stable is lifestyle change. I have a close friend that had three stints implanted a few years ago. He took that warning as a real wake-up call and begin cycling. In the first year, he rode over 3,500 miles and lost 60 pounds. His heart disease is stable, not from the stints, but from improving his diet and adding exercise.

I have a strong history of heart disease in my family. My father died at the age of 47 from a massive heart attack. My mother had her first of five heart attacks at the age of 37. My older brother had quadruple by-pass surgery when he was in his 40’s and now has a pacemaker. My younger brother had a stint implanted when his was in his 40’s as well.

I have taken a different route, using diet, exercise and nutritional supplementation rather than drugs and surgery.

The Bottom Line:
Please avoid cardiac angioplasty unless you are having a heart attack. Better yet, be pro-active and adopt a lifestyle that will avoid the question entirely.

Source: November 11, 2015 National Institutes of Health

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