Thursday, August 18, 2022
Germany Latest News
  • Sports
  • USA
  • Asia
  • Health
  • Life Style
  • Tech
  • Science
  • Latin America
  • Africa
  • Europe
No Result
View All Result
Germany Latest News
Home Health

Are Stents Really Useless After Chest Pain? Cardiologists Not Sure

by The Editor
November 3, 2017
in Health
0
0
SHARES
0
VIEWS
Share on FacebookShare on Twitter

FRIDAY, Nov. 3, 2017 (HealthDay News) — Heart experts are cautiously embracing the results of a new, landmark clinical trial that questions the value of opening blocked arteries to relieve chest pain.

Chest pain sufferers who received a stent — a tiny wire mesh tube — to reopen an obstructed artery did not show any more improvement than people who only took medicine to improve their condition, the British researchers reported.

Related posts

US follows UK’s lead and shortens isolation for healthcare workers who test positive for Covid-19

US follows UK’s lead and shortens isolation for healthcare workers who test positive for Covid-19

December 24, 2021
Covid booster jab triggers immune response in days, not weeks, say scientists

Covid booster jab triggers immune response in days, not weeks, say scientists

December 20, 2021

"This definitely has made big waves," said Dr. Samin Sharma, director of interventional cardiology at Mount Sinai Health System in New York City.

But cardiologists can't say whether the trial, published Nov. 2 in The Lancet journal, will have much immediate impact on clinical decision-making.

For one, the trial focused on a set of patients with relatively mild symptoms, and it did not include a long enough follow-up to see whether those who didn't receive stents wound up with ever-worsening heart problems.

"As a physician who has cared for many patients with coronary artery disease, I have grave concerns about overgeneralizing the results of the trial to patients with more severe symptoms and limitations from their coronary artery disease," said Dr. Ajay Kirtane, director of the Cardiac Catheterization Laboratories at New York-Presbyterian/Columbia University Irving Medical Center in New York City.

Stents are proven lifesavers for people suffering from a heart attack due to a blocked artery, and also undeniably improve the health of people with unpredictable bouts of chest pain, said Sharma and Dr. Sidney Smith, an American Heart Association spokesman and professor with the University of North Carolina School of Medicine.

But there's been some serious debate over the benefits of stenting in people with stable angina — predictable, short-lived chest pain that occurs when stress is placed on the heart. Angina is typically caused by the buildup of fatty plaques in the arteries.

The latest trial addressed this question using methods relatively unique in modern medicine, cardiologists said.

The researchers randomly performed a "sham" stenting procedure on half of 200 patients with stable angina, to see if they experienced the same improvement as those who did get a partially blocked artery reopened with a stent. All of the patients received aggressive drug treatment for their chest pain.

The findings have rocked the heart health world. Patients who underwent the fake procedure improved just as much as those who received stents. They reported less chest pain and improved their performance on treadmill tests.

However, questions already are being raised about how applicable the results will be for the world at large.

The British trial involved a very select group of chest pain patients, heart experts noted.

"The fact that it took 3 1/2 years and five large hospitals to enroll only 200 patients suggests that this strategy was applied to a small fraction of patients who were seen at those hospitals," said Dr. Cindy Grines, an interventional cardiologist with Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.

For example, the patients' chest pain had to come from only one blocked artery, said Dr. Mary Norine Walsh, president of the American College of Cardiology.

"They didn't include anybody who had more than one vessel seriously narrowed," Walsh said. "We can't extrapolate this study to other patients with more than one vessel involved."

The patients also appeared to be in relatively good health, and initially were able to spend more than eight minutes on a treadmill. That "suggests this is a very low-risk group in whom one could have predicted patients may not benefit from" receiving a stent, Grines said.

But the greatest concern over the trial involves the six-week follow-up period, which many considered too short.

"The true impact clinically of this trial requires more than a six-week follow-up," Smith said. "We need to know what happens to the unstented lesion over a longer period of time."

Previous trials of stenting and other heart procedures typically have followed patients out for six to nine months or even longer, Sharma said.

For example, another clinical trial found that it took at least six months for patients who didn't receive a stent to run into trouble, either suffering a heart attack or requiring an emergency angioplasty, Sharma said.

"The benefit of the stent procedure may not be known at six weeks," Sharma said. "It may take a little longer. If I had designed the study, I would have kept it at six months."

Walsh agreed. "Whether or not long-term people do as well on medical therapy is really not known. This study doesn't answer that question," she said.

Longer follow-up trials will be needed to see whether a purely drug-based approach is better in the long run for patients with stable angina, experts said.

In the meantime, the latest study could promote better conversations between cardiologists and their patients, Walsh said.

"For the patient who is similar to the patients in this trial, that type of patient with one-vessel disease should certainly be in conversation with his or her cardiologist about whether maximizing medical therapy would be as beneficial," Walsh said.

"There are many patients who may prefer stenting, who don't wish to be on as many medications, for example," Walsh continued. "A lot of this really will come down to doctors and patients talking to each other, reviewing this important new piece of data, and making a decision together."

The trial is also a reminder that cardiologists "have to be more careful and analytical of which patients receive a stent," Sharma said.

One relatively recent innovation involves a test of fractional flow reserve (FFR), which measures blood pressure and blood flow through partial blockages of an artery, Sharma said.

Nearly every catheterization lab in the country has one of these devices, which have been shown to accurately predict who needs a stent, regardless of how blocked their artery has become, Sharma said.

In fact, all of the patients in this latest trial underwent an FFR test, and the results showed that about 30 percent had an FFR that would have led them to be placed on medication rather than receive a stent, Sharma noted.

"At present in stable angina, we do additional testing to see whether that blockage is going to give the patient trouble in the future," Sharma said, estimating that about 4 out of 6 patients are placed on drug therapy following their FFR test.

More information

Visit the American Heart Association for more on angina.

Let's block ads! (Why?)

Original Article

Previous Post

Estonia’s online ID system locked due to flaw

Next Post

Nursing Home Often Only Option for Single Men After Stroke

Next Post

Nursing Home Often Only Option for Single Men After Stroke

RECOMMENDED NEWS

‘I’m hanging myself at this point’: UFC star Mike Perry details potentially tragic training accident

‘I’m hanging myself at this point’: UFC star Mike Perry details potentially tragic training accident

3 years ago

Call it a day, killer androids. We humans submit

3 years ago
The ZMF Auteur is a fancy, crafted set of headphones     – CNET

The ZMF Auteur is a fancy, crafted set of headphones – CNET

4 years ago
Health groups warn Brexit drugs supply risk at code red

Health groups warn Brexit drugs supply risk at code red

4 years ago

FOLLOW US

  • 116 Followers
  • 86.9k Followers
  • 166k Subscribers

BROWSE BY CATEGORIES

  • Africa
  • Asia
  • Europe
  • Health
  • latest news
  • Latin America
  • Life Style
  • Science
  • Sports
  • Tech
  • Uncategorized
  • USA

BROWSE BY TOPICS

2018 League Bali United Beijing BlackBerry Brazil Budget Travel Bundesliga California Champions League Chelsea China Chopper Bike Coronavirus COVID COVID-19 Crime Doctor Terawan EU forces France French German GISAID Istana Negara Italy Lewandowski Lionel Messi Market Stories Mexico National Exam Nigeria Omicron Pakistan Police protect protests Qatar Russia slapstick South Africans TikTok Trump UK Ukraine Visit Bali
No Result
View All Result

Recent Posts

  • Dominican Republic environment minister shot dead in his office
  • France puts 18 on trial over alleged involvement in vast horsemeat scandal
  • North Korea fires ballistic missiles a day after US-South Korean naval drills
  • Nigeria: town mourns more than 50 people shot dead in church during mass
  • Death toll rises after train crash in Bavaria

Categories

  • Africa
  • Asia
  • Europe
  • Health
  • latest news
  • Latin America
  • Life Style
  • Science
  • Sports
  • Tech
  • Uncategorized
  • USA

Tags

2018 League Bali United Beijing BlackBerry Brazil Budget Travel Bundesliga California Champions League Chelsea China Chopper Bike Coronavirus COVID COVID-19 Crime Doctor Terawan EU forces France French German GISAID Istana Negara Italy Lewandowski Lionel Messi Market Stories Mexico National Exam Nigeria Omicron Pakistan Police protect protests Qatar Russia slapstick South Africans TikTok Trump UK Ukraine Visit Bali
Death toll rises after train crash in Bavaria
latest news

Death toll rises after train crash in Bavaria

by The Editor
June 6, 2022
0

Several people were killed and 40 more were injured on Friday when a regional passenger train derailed in the southern German...

Read more

Recent News

  • Dominican Republic environment minister shot dead in his office
  • France puts 18 on trial over alleged involvement in vast horsemeat scandal
  • North Korea fires ballistic missiles a day after US-South Korean naval drills

Category

  • Africa
  • Asia
  • Europe
  • Health
  • latest news
  • Latin America
  • Life Style
  • Science
  • Sports
  • Tech
  • Uncategorized
  • USA

Recent News

Dominican Republic environment minister shot dead in his office

Dominican Republic environment minister shot dead in his office

June 6, 2022
France puts 18 on trial over alleged involvement in vast horsemeat scandal

France puts 18 on trial over alleged involvement in vast horsemeat scandal

June 6, 2022
  • About
  • Advertise
  • Careers
  • Contact

© 2022 JNews - Premium WordPress news & magazine theme by Jegtheme.

No Result
View All Result
  • Sports
  • USA
  • Asia
  • Health
  • Life Style
  • Tech
  • Science
  • Latin America
  • Africa
  • Europe

© 2022 JNews - Premium WordPress news & magazine theme by Jegtheme.