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Study Questions Angioplasty Use in Some Patients
NY Times ^ | November 15, 2006 | DENISE GRADY

Posted on 11/14/2006 11:20:08 PM PST by neverdem

Opening a blocked artery with balloons and stents can be lifesaving in the early hours after a heart attack, but a new study concludes that it often does no good if the heart attack occurred three or more days before.

The findings should change medical practice, researchers say, and could affect as many as 50,000 patients a year in the United States. They say doctors should stop trying to open arteries in people who had heart attacks days or weeks before and who are stable and free of chest pain.

Currently, the balloon procedure, called angioplasty, is used in many of those patients, along with stents, devices implanted to prop open an artery. When patients receive treatment late, it is often because they did not realize that they had had a heart attack and delayed going to the doctor or hospital. In some cases, too, doctors may not make the correct diagnosis right away.

The new study “should change practice, and I believe it will,” said Dr. Judith S. Hochman, director of the cardiovascular clinical research center at New York University medical school, and leader of the study, which included 2,166 patients at 217 hospitals in the United States and other countries.

Dr. Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute, which helped pay for the research, said: “This is an important study. It’s definitive. The evidence...”

--snip--

A million Americans a year have heart attacks, and half of them die, according to the National Heart, Lung, and Blood Institute. A common symptom is severe pain in the chest, left arm, jaw or back, but about a third of patients do not have chest pain. Symptoms may also include feeling faint, sweaty, short of breath or nauseated and having a sensation that the heart is pounding.

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Extended News; News/Current Events
KEYWORDS: cad; health; heart; medicine; stents
That 1/3 of patients without any pain are typically diabetics. They commonly describe a "heaviness in the chest."

Coronary Intervention for Persistent Occlusion after Myocardial Infarction

That's a link to the abstract. A link to the pdf for the complete article can be found there on the upper right.


Hiroko Masuike for The New York Times
Bare metal stents are often implanted to prop open an artery.

1 posted on 11/14/2006 11:20:12 PM PST by neverdem
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To: neverdem
So after a heart attack has occurred 2 days before it's OK to do a cardiac cath and stent any occlusions? It's just no good after 3 days?
2 posted on 11/15/2006 4:59:03 AM PST by AmericaUnite
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To: neverdem

I curious why they said that a significant confounder with respect to age was probably an artifact.


3 posted on 11/15/2006 7:48:01 AM PST by cosine
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To: AmericaUnite
So after a heart attack has occurred 2 days before it's OK to do a cardiac cath and stent any occlusions? It's just no good after 3 days?

That's the concclusion if you're not having symptoms.

4 posted on 11/15/2006 8:44:18 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: cosine
I curious why they said that a significant confounder with respect to age was probably an artifact.

Where's that, the Times' story or the pdf?

5 posted on 11/15/2006 8:46:39 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem

concclusion = conclusion


6 posted on 11/15/2006 8:48:02 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: El Gato; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; Dianna; ...
Fish Oil Linked to Lower Alzheimer’s Risk

Fingerprint database lets police identify criminal immigrants

FReepmail me if you want on or off my health and science ping list.

7 posted on 11/15/2006 9:39:46 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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