Delayed angioplasty no more effective than drugs
If patients' blocked coronary arteries are not opened immediately with angioplasty and stents, but only after a few days, their risk of another heart attack is just as high as in people who are subsequently only treated with heart medication. Until now, doctors had assumed that a late operation also reduced this risk.
In an international study, the he alth of over 2,000 heart attack patients was tracked for an average of three years. Three days to four weeks after the heart attack, randomly selected patients not only received balloon dilatation – in which the blocked vessel is made permeable again via a balloon inserted and then inflated – but also received a stent. This is intended to prevent renewed narrowing of the vessel by means of a thin wire framework. In addition, they were treated with medication - like the other patients who had not undergone surgery.
Finally, when the researchers compared the risks of another heart attack, other cardiovascular disorders and death, they found no significant difference between the groups. They even noticed an emerging trend for higher risk among those who had surgery.
Judith Hochmann from New York University explains this by saying that smaller coronary arteries take over the work of redirecting blood flow if the actual clot persists. If this is removed, these capillaries could recede or even close and would therefore not be available if they were blocked again. However, since the trend is not significant, follow-up studies would have to shed more detail.
The best prospects are if the blocked vessels are opened by angioplasty or anticoagulants within twelve hours after the infarction. The scientists estimate that about a third does not reach the hospital in time for this. (af)
