A major international trial has found that high-risk patients who have stable heart disease may be treated well with medications alone rather than invasive cardiac procedures, such as stents and bypass surgeries.
The findings of the trial were presented Saturday at the American Heart Association’s annual conference.
The trial looked at more than 5,000 patients across 37 countries.
The invasive procedures have been found effective at improving chest pain and overall quality of life but the prognosis did not differ significantly, such as subsequent heart attack, hospitalization for unstable angina (chest pain) or heart failure, resuscitation after a heart attack, and death from cardiovascular events.
Study author Dr. Judith Hochman said, “Patients want to know, is this treatment going to make me live longer? Based on what we saw, we did not see evidence that would make them live longer.”
The invasive surgeries are commonly performed on patients with heart attack, but whether or not to intervene with patients who have stable heart disease has been hotly debated.
The patients with unstable heart disease are those who have blockages or angina during exercise but not an acute heart attack.
The study did not look at patients with heart attack, poor heart function, or narrowing of the coronary artery.
Dr. Hochman explained, “We selected patients with a very abnormal stress test,” when it came to patients with stable heart disease. She added, “Is it was thought that if anybody is going to benefit from an invasive strategy of stenting or bypass surgery, those were the patients that would benefit.” She noted that millions of dollars could be saved if asymptomatic patients do not undergo invasive therapies. She said, “The implications are quite large globally and in the United States.”
