Can you skip stents as a way to treat heart disease? New research finds that in some cases stents and bypass surgery may not be needed.
This study was presented Saturday at the American Heart Association annual meeting in Philadelphia. It looked at more than five thousand people with blocked arteries -- but no symptoms. It found that regularly taking medications along with lifestyle changes were just as effective at preventing heart attacks as the more invasive procedures.
"This doesn't apply to everybody who has coronary artery disease," said Dr. Michael Lim, a SLU Care cardiologist at SSM Health Saint Louis University Hospital. "If you have had or are having a heart attack or an unstable situation -- such as an immediate onset of severe chest pressure or discomfort -- this study does not apply to you. This is a different category of people we call "stable patients" -- where there are symptoms that are reliably predictable, can be lifestyle limiting or problematic, but you are not in a situation where you potentially are limited in terms of your life."
"There certainly are patients who still will get stents," said CBS News Medical Contributor Dr. Tara Narula, a cardiologist at Northwell Health. "Those with unstable angina where the chest pain is really getting worse and worse and more severe -- or they have had a heart attack, or very severe disease in their arteries. But for those other patients, certainly those who have no symptoms, there really may not be a benefit. And if you have mild symptoms, then it's really going to be a shared decision making strategy where you talk to your doctor and you say 'Am I optimized on my medical therapy, my statins, my blood pressure medication, my lifestyle or can I do better?'"
"What it shows us is medications are really good, and when appropriately used stents or bypass surgery is really good," Dr. Lim tells KMOX. "But one or the other is not necessarily absolutely the best thing ever."
The bottom line on this study -- according to Dr. Lim?
"We need to really think about individual patients as individuals," said Dr. Lim. "We need to weigh the pros and cons for when medications can be applied in isolation - without catheterization, stents or bypass surgery. And which patients and for whom we apply those more invasive measures to improve their health."
Experts say this finding should make it easier for doctors to avoid immediately sending patients with clogged arteries into cath labs -- especially in non-emergency situations where they are not suffering any symptoms.
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