Stable heart disease patients treated with medication are at no higher risk of death or heart attack than their peers who receive invasive procedures to unblock arteries, a major new study has found.
The results may upend decades of standard clinical practice, said David Maron, M.D., of Stanford University, and colleagues. Angioplasty, stenting and heart bypass surgery have long been viewed as the most effective ways to reduce the risk of dangerous cardiac events in these patients.
In fact, the researchers found that invasive procedures were no more effective in preventing heart attack or death than treating patients with aspirin, statins and lifestyle advice.
If stents and bypasses did not carry risks, the study may instead have shown an overall benefit from these procedures, said Maron. “But that’s not what we found. We found an early harm and later benefit, and they canceled each other out,” he reported.
“I do see this as reducing the number of invasive procedures,” added co-investigator Robert Harrington, M.D., also of Stanford.
Investigators did find one relative advantage to surgically unblocking arteries in stable heart patients, however. These procedures were more effective in relieving pain and improving the quality of life for people who had angina, or severe chest pain caused by inadequate blood supply to the heart.
The study involved more than 5,000 participants in 37 countries and over $100 million in funding. The results do not apply to people with acute heart conditions, such as those having a heart attack, the researchers said.
Full findings were presented on Saturday at the American Heart Association’s Scientific Sessions 2019 in Philadelphia.
