This past February, the volume of Archives of Internal Medicine published a study that found less is more when it comes to treating stable coronary artery disease.
Authors Kathleen Stergiopoulos, MD, PhD, and David L. Brown, MD, both of Stony Brook University Medical Center in New York, reviewed the cases of more than 7,000 patients treated for stable heart disease in clinical trials between 1997 and 2005. Of the patients followed, about half received treatment consisting of stents with medication and the other patients received treatment of medication alone.
In reviewing the cases, Brown and Stergiopoulos found that compared to treating with medication alone, surgically opening unhealthy arteries (coronary angioplasty) and stenting to prop the arteries open failed to result in:
- Reduced fatalities
- Nonfatal heart attacks
- Emergency bypass procedures
- Shortness of breath
- Chest pain
Yet, aggressive therapy using medicine alone as a first-line treatment option provided the benefits needed by the majority of heart-disease patients for treating atherosclerosis. Only one-third of the patients studied ultimately required stents because medication was not effective.
Inadequacy of Stents to Stabilize Coronary Artery Disease
Based on their findings, the Stony Brook researchers concluded that there is no benefit to using stents for stable coronary artery disease as an initial therapy for preventing nonfatal myocardial infarction, unplanned revascularization, angina or death. Additionally, the American Heart Association and the American College of Cardiology both recommend first using an aggressive medication regime for treating heart-related chest pain with exertion or asymptomatic narrowed arteries.
With more than 400,000 nonemergency stenting procedures performed each year, the findings of this study are of concern to patients and physicians. According to MayoClinic.com, angioplasty carries serious risks to the patient. These risks include bleeding and blood clots, heart attack and stroke, kidney problems and renarrowing of arteries. Angioplasty patients also may needlessly face other risks of surgical complications such as infections, medical errors (medical malpractice), dangerous and defective stents and potential recall issues.
Consulting With a New York Medical Malpractice Lawyer
Before pursuing surgical intervention as the first-line of treatment, patients would be wise to seek a second opinion to determine if medication alone would be of more benefit. And if a surgical procedure had been completed but patients and their loved ones believe it was unnecessary or complications resulted, consulting with an experienced medical malpractice attorney to determine if legal action is warranted is recommended.