In April I lost a close friend whose unnecessary stent had led to complications that led to unsuccessful surgery. My friend was an independent thinker but a compliant patient —one of thousands who had not suffered heart attacks but were sold stents and bypass procedures on the basis of exercise stress tests, supposedly to fend off future attacks. Now a major study shows that these interventions serve no protective purpose. As Gina Kolata reported in the New York Times Nov. 16:
The findings of a large federal study on bypass surgeries and stents call into question the medical care provided to tens of thousands of heart disease patients with blocked coronary arteries, scientists reported at the annual meeting of the American Heart Association on Saturday.
The new study found that patients who received drug therapy alone did not experience more heart attacks or die more often than those who also received bypass surgery or stents, tiny wire cages used to open narrowed arteries…
With its size and rigorous design, the new study, called Ischemia, was intended to settle questions about the benefits of stents and bypass… The results will be incorporated into treatment guidelines…
The participants in Ischemia were not experiencing a heart attack, like Senator Bernie Sanders, nor did they have blockages of the left main coronary artery, two situations in which opening arteries with stents can be lifesaving. Instead, the patients had narrowed arteries that were discovered with exercise stress tests.
With 5,179 participants followed for a median of three and a half years, Ischemia is the largest trial to address the effect of opening blocked arteries in nonemergency situations and the first to include today’s powerful drug regimens.
The reference to Bernie Sanders seems gratuitous —a reminder that the 78-year-old Senator may not be durable (like Mayor Pete or Ambitious Amy).
