About three-quarters of the participants had a scan of their coronary arteries to make sure they had obstructive coronary disease. Those without narrowings in their arteries, or with a blockage in a main artery that supplies blood to a large portion of the heart were excluded, Dr. Hochman said. The participants then underwent a stent or bypass procedure along with intensive medical and lifestyle therapy, or were put on intensive medical and lifestyle therapy alone. That included cholesterol- and blood-pressure-lowering drugs, smoking cessation and changes in diet. Modern drug-eluting stents, which slowly release drugs to decrease the chances that blockages will recur, were used.
Researchers monitored participants for any of five events: a cardiovascular-related death, heart attack, resuscitation after cardiac arrest or hospitalization either for unstable chest pain or heart failure. There was no difference in the rate of those five disease-related events in both groups overall, Dr. Hochman said. The result was the same when comparing results for two serious events: heart attacks and a cardiovascular-related death, she said.
There were differences between the groups at certain points within those four years, the results showed. Six months into their treatment, the group with invasive procedures suffered a heart attack or other event at a higher rate—5.3%—than the group receiving medical therapy only, at 3.4%, suggesting complications from the procedures, Dr. Hochman said.
Half of patients who had invasive procedures for frequent chest pain were free of their symptoms a year after their treatment, compared with 20% who reported improvement after medical and lifestyle therapy alone, the researchers found, citing a likely benefit of modern, drug-eluting stents.
https://www.wsj.com/articles/study-finds-limited-benefits-of-stent-use-for-millions-with-heart-disease-11573931727 (paid subscription)
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