Stenting Can Be Beneficial for Some Heart Patients
Posted March 30, 2007 2:51 p.m. EDT
Updated March 30, 2007 8:46 p.m. EDT
Raleigh, N.C. — Researchers found angioplasty with stents used to open clogged heart arteries did not prolong life or prevent heart attack in patients with stable heart disease. However, many cardiologists said people need a better understanding of what the procedure's real benefits are for different patients.
Health experts claim angioplasty with stenting is the most common heart procedure. WakeMed cardiologist Dr. Tift Mann can reach blocked arteries in the heart either through a main artery in the leg or through the wrist.
In the procedure, through a catheter, a balloon pushes the plaque back in the blocked heart artery. Then, a drug-coated metal stent keeps plaque from reforming in the same place. Mann said the procedure can only do so much.
"Arteriosclerosis is a chronic progressive disease. We don't cure it with stents. We don't cure it with bypass surgery," he said.
Both procedures are done in combination with medication, including cholesterol-lowering statins. Patients also must make drastic lifestyle changes in diet and exercise. Researchers said many patients must quit smoking, which is a major risk factor for heart disease.
The study in the New England Journal of Medicine said angioplasty and coronary stenting do not prolong life or reduce the risk of heart attack in patients with stable coronary disease. However, there are other obvious benefits to the procedure.
"The purpose of stents are to relieve symptoms. It's not to prolong life or prevent heart attacks in a stable group of patients," Mann said.
Patients with stable coronary disease experience chest pain when they exert themselves. On the other hand, patients with unstable coronary disease experience continuing chest pain even when they are at rest. For an acute group of patients, those who have a sudden blockage of coronary arteries, Mann said stents have been shown to prevent heart attacks and prolong life.
Even for stable heart patients, stenting provides better relief from chest pain, or angina, than medications alone, which is what many of Mann's patients want.
"I think the key feature is that patients with coronary disease want to live a normal life just like you and me," Mann said.
Mann recommends that, before agreeing to a stenting procedure, patients ask their cardiologist what their options are and why the doctor might think stenting is the best choice for them.
The best way to prevent heart disease is to reduce controllable risk factors. It is also important not to smoke, keep your cholesterol level below 200, maintain a healthy weight and get daily exercise.