Health Care

Heart stents don't actually help treat chest pain

While stents can save lives when used to open arteries in heart attack patients, they are most commonly used to open blocked arteries in patients who experience chest pain during moderate physical exertion. They said some patients might want it anyway to potentially cut down on their need to take medications to reduce chest pain.

The subject had an extreme blockage however just in one supply route, he stated, and they were surveyed after just a month and a half.

Heart disease is still the leading killer of Americans — 790,000 people have heart attacks each year — and stenting is a mainstay treatment in virtually every hospital. Other estimates are much higher.

"The most important reason we give patients a stent is to unblock an artery when they are having a heart attack", Dr. Rasha Al-Lamee of Imperial College in London said in a statement.

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

The new study, published in the Lancet, shocked top cardiologists and raises questions about whether stents should be used as often - or at all - to treat chest pain.

"Its a very humbling study for someone who puts in stents", said Dr. Brahmajee K. Nallamothu, an interventional cardiologist at the University of MI.

Dr. Vinay Prasad, an oncologist at Oregon Health & Science University and study specialist, was not surprised by the result.

Dr. David Maron, a cardiologist at Stanford University, described the study as "very well conducted" - but said it left some questions unanswered.

Cardiologists told the New York Times that one reason might be that atherosclerosis affects many blood vessels, and stenting only the largest blockage may not make much difference in a patient's discomfort.

"We don't know if the conclusions apply to people with more severe disease", Maron said. "What's more, we don't know whether the determinations apply for a more drawn out time of perception".

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The study included 200 patients with stable angina who received six weeks of intensive drug treatment for their angina. Then, some received surgery to insert a real stent while some got a fake procedure; neither the patients nor the researchers knew which group they were in.

The study was based on a clinical trial in Britain involving 200 patients with a blocked artery and angina. Once the catheter reached the site, the doctor inserted a stent or, under the fake procedure, pulled out the catheter.

Patients in both groups did better on the treadmill and reported reduced symptoms though patients who received a stent were able to exercise longer.

Everyone was wheeled into the operating room and underwent a procedure. Other studies have found that stents relieve chest pain but in this one a group of randomly picked patients were made to believe that they underwent a stent procedure when they did not. But there was no real difference between the patients, the researchers found.

Even the patients who got the stents didn't fare better than those in the placebo group, according to the new research.

The individuals who report feeling better may just experience a misleading impact from the system, the said.

"It's a very humbling study for someone who puts in stents", says a cardiologist at the University of MI.

As a press release explains, the new study was focused on patients with only narrowed arteries, meaning they would be getting the procedure for pain relief.

He also said the study was well done but said it was too small to be conclusive.

He said cardiology studies often enroll thousands of patients.



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