New research shows that a preventive heart procedure could cut death risk by two-thirds. It's aimed at those who suffer severe heart attacks and have blockages in arteries besides the one that caused the attack.
"If these results are confirmed then it might substantially change the guidelines in the United States," said Dr. Prospero Gogo, a cardiologist at Fletcher Allen Health Care in Burlington.
Right now those guidelines from the American Heart Association and the American College of Cardiology say when someone suffers the most serious kind of heart attack, those caused when a clot completely blocks blood flow to the heart; you fix that artery and only that artery, even if others have partial blockages. Doctors do that by performing an artery-opening angioplasty.
"And the reason why is because a lot of the data driving this is somewhat older data with some of the older equipment possibly that suggested that if you have three arteries in the heart-- this one causing your heart attack-- and if you try to fix this one, as well, you put two areas of your heart in jeopardy possibly if you have a complication fixing the non-culprit artery," Gogo explained.
But now, a new study published in the New England Journal of Medicine shows a 65-percent risk reduction in those who had stents put in other arteries, as well. In the study, 234 patients had preventive procedures. In 231, only the culprit artery was opened. And within two years, 21 patients in the preventive group and 53 in the culprit-only group either died, had another heart attack or developed chest pain called angina.
"I think it's very promising," Gogo said. "Like I said, our standard practice is only to fix the culprit vessel and sometimes it's hard to leave. You have a 100-percent blockage that's causing the heart attack, but on the other side of the heart you see a 90-percent blockage. Sometimes it's very hard to leave that alone."
But now there's more credence that perhaps doctors should attempt to fix those arteries, as well, before they become a problem. With more confirmation, Gogo notes the difference in death rates could be dramatic.
Fletcher Allen ranks in the top 5 percent of hospitals nationwide for its low rate of readmissions following stent procedures; 1 in 7 goes back within 30 days.
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