Angioplasty better than drugs for preventing second heart attack

May 14 2007

After suffering a heart attack many patients still have low blood flow to the heart tissue while experiencing no symptoms and new research suggests that angioplasty is more effective than drugs for preventing second heart attacks in this situation.

A study started from May 1991 to March 1997, involved 201 heart attack survivors with recognised heart vessel blockage, but with no chest pain or other symptoms.

In the 10-year follow-up study in May 2006 it was found that 67 of the 105 drug-treated patients had suffered another major cardiac event, compared with 27 of the 96 patients who had angioplasty.

Those treated with angioplasty and drugs rather than with medication alone appear to have faired much better.

Researcher Dr. Paul Erne says the findings show that later angioplasty is an important preventive strategy for preventing second heart attacks in asymptomatic patients.

Dr. Paul Erne says they found a consistent benefit for this intervention in patients who did not have chest pain or other symptoms.

The patients in the study had suffered their heart attacks within three months of enrolling in the trial and though they did not have chest pain or other symptoms, they did have heart monitor abnormalities consistent with artery blockage confirmed through exercise stress tests.

The angioplasty patients did not have stenting as at the time the procedure was not standard practice.

All the patients in the trial took aspirin, cholesterol-lowering statins, and blood pressure medications.

Experts however say the study is too small to prove the value of angioplasty over drugs for asymptomatic heart patients and major advances in both angioplasty and drug therapies for heart disease in the 10 to 15 years since the patients in the study were treated, further cloud the interpretation of the findings.

Angioplasty involves a tiny catheter being inserted in an artery in the leg and then, under X-ray guidance, the tip is extended into the coronary arteries feeding the heart.

A tiny balloon is then inflated, which opens the blocked artery, ideally restoring blood flow to the heart tissue.

Today angioplasty is often accompanied by the placement of a stent to keep the narrowed artery open.

The study appears in the May 8 issue of the Journal of the American Medical Association.