New Research Reveals Potential Alternative to Invasive Heart Surgery

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Recent studies point toward the viability of exclusively drug-based therapies for treating arterial blockages

By John Delehanty, CR News Science Writer

Arterial plaques and narrowing of blood vessels can have any of a number of deleterious downstream effects, including heart attack and stroke. Bypass and stents are traditionally viewed as an effective means of treating arterial narrowing, thus preventing potentially fatal complications. However, new research points to noninvasive methods that are as effective for some patients.

A federal study on invasive bypass and stent procedures seems to indicate that these procedures may not be any more effective than a combination of medication and life-style changes in correcting blocked coronary arteries. The study, appropriately titled Ischemia, found that patients whose arterial blockages were treated with only drug therapy did not experience more heart attacks or a higher associated mortality rate than those who also received bypass or stent surgeries in addition to drug treatment.

” A federal study on invasive bypass and stent procedures seems to indicate that these procedures may not be any more effective than a combination of medication and life-style changes in correcting blocked coronary arteries.”

The basis of analysis for this study was a group of patients seeking treatment for narrowed arteries. This narrowing typically results from plaque buildup on the interior of vessels which obstructs blood flow. These plaques may exist singly, or throughout the coronary arteries, with either scenario resulting in limited blood flow and overall poor cardiac health. 

The Ischemia finding was true for patients diagnosed with multiple arterial blockages who were not suffering from angina. Stenting and bypass interventions did help in resolving intractable chest pain, or angina, associated with arterial obstruction.

The study focused on patients experiencing light to moderate ischemia, or a restriction in blood supply to tissues resulting in a shortage of the oxygen needed to keep those tissues alive. All patients were generally regarded as low-risk, for whom lifestyle and drug interventions would prove adequate or even ideal in treating their condition. Patients experiencing more severe blockages were not the focus of the study, and bypass or stent intervention for this higher-risk group remains a lifesaving intervention. 

” Bypass and stents are traditionally viewed as an effective means of treating arterial narrowing, thus preventing potentially fatal complications. However, new research points to noninvasive methods that are as effective for some patients.”

This is not the first study to find that bypass and stent applications are potentially overprescribed. However, these past studies were criticised for not controlling for factors like LDL cholesterol, nor for advances in stent technology that allows for the slow release of pharmaceuticals that prevent arteries from closing. In correcting for these variables, the research plainly shows that for some patients there exists a viable alternative to invasive treatments.

Sources:

Saacks, B. (2019, November 16). Heart surgeries like bypasses may not be necessary for blocked arteries, according to groundbreaking new research. Retrieved from https://www.businessinsider.com/federal-study-shows-that-some-heart-surgeries-arent-needed-2019-11.

International Study of Comparative Health Effectiveness With Medical and Invasive Approaches. (2019, November 16). Retrieved from https://www.acc.org/latest-in-cardiology/clinical-trials/2019/11/15/17/27/ischemia.

Kolata, G. (2019, November 16). Surgery for Blocked Arteries Is Often Unwarranted, Researchers Find. Retrieved from https://www.nytimes.com/2019/11/16/health/heart-disease-stents-bypass.html.