Results of a new study have shown that heart stents are no more effective than medicines when it comes to relieving chest pain.
Stents are mesh-wire tubes inserted into narrow or weak arteries to widen them and increase blood flow to relieve in stable angina or chest pain.
Having a stent placed in a coronary vessel to relieve chest pain may be of no benefit for some heart patients despite the procedure being one of the most common in cardiac care, researchers said.
For the study, Dr. Justin E. Davies, a cardiologist at Imperial College London and his colleagues recruited 200 patients with a profoundly blocked coronary artery and chest pain severe enough to limit physical activity, common reasons for inserting a stent.
All were treated for six weeks with drugs to reduce the risk of a heart attack, like aspirin, a statin and a blood pressure drug, as well as medications that relieve chest pain by slowing the heart or opening blood vessels.
Interventional cardiologists inserted a stent in 105 of the patients and also prescribed potent anti-clotting medication.
Ninety-five patients underwent what’s called a “sham” procedure. They were wheeled into the cardiac catheterization laboratory and a catheter was threaded through an artery, but they did not receive a stent.
When the researchers tested the patients six weeks later, both groups said they had less chest pain and they did better than before on treadmill tests.
But there was no real difference between the patients, the researchers found. Those who got the sham procedure did just as well as those who got stents.
“Surprisingly, even though the stents improved blood supply they didn’t provide more relief of symptoms compared to drug treatments, at least in this patient group,” said Al-Lamee, an interventional cardiologist.
“All cardiology guidelines should be revised,” Dr. David L. Brown of Washington University School of Medicine and Dr. Rita F. Redberg of the University of California, San Francisco, wrote in an editorial published with the new study.
Considering the high costs, the study’s results suggest that cardiologists should think twice about prescribing heart stents simply to treat chest pain and when the situation is not necessarily life-threatening.
At the end of the study, the researchers said, “there is no evidence from blinded, placebo-controlled randomised trials to show its percutaneous coronary intervention efficacy”.
The safety of stents was not challenged and they’re still considered to be quite safe. The study was published in the journal The Lancet.