Stent-deposits, or Bypass OPs are among the most common invasive procedures to treat diseases of the coronary vessels. But whether they are always necessary, is unclear.
American researchers have now found in a large-scale study found that patients with stable coronary heart disease often benefit from the interventions: drug therapy, and General lifestyle changes can be just as effective as operative measures.
Bottlenecks in one or more coronary arteries are often the result of atherosclerosis, and can lead to a lack of oxygen in Parts of the heart. Doctors speak of coronary or ischemic heart disease (CHD). These include, in Germany, one of the most common causes of death. Dangerous heart rhythm disturbances, heart failure, or a heart attack are also.
In addition to prevention through healthy diet, refraining from cigarettes and adequate exercise medications can help expand the blood vessels and the oxygen utilization to improve. The effective treatment of high blood pressure or Diabetes mellitus, are part of a comprehensive therapy.
In addition to these treatment options, the vessels can be kept high by the Use of Stents open. Stents are small mesh tubes that are placed via a cardiac catheter into the narrowed coronary arteries. Newer coated Stents give off in addition, drugs that prevent the vessels zuwuchern again. Their Use is controversial, because patients often need to pull after the Intervention re-intervention. In the case of a Bypass open-heart SURGERY on one or more of the coronary vessels by veins from the legs or arteries from the chest wall replaced (read here for more on the criticism of Stents).
In the case of chest pain, Stents can help
The International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA), which was funded by the NYU Langone Health Center in New York, came to the following results:
- Stents or Bypass surgery do not protect better against heart attacks or deaths from cardiac arrest as a medication.
- The interventions provide patient with chest pain , however, proven relief.
- In people without chest pain have is no advantage compared to a drug therapy.
In the study 5179 people took part, suffering from narrowed arteries, but not in a health emergency situation were. Every fifth of them complained of pain on a regular chest. Treatment methods the patients were selected randomly: for a single drug therapy, the Insertion of Stents or Bypass SURGERY.
145 patients with Stent or Bypass died, 276 of them suffered a heart attack. Of the patient, the only medicines, have died 144 and 314 suffered a heart attack. The researchers, who presented their results at a Meeting of the American Heart Association on the weekend, and conclude that there are several years with stable coronary heart disease no major difference between invasive and drug therapies, except in respect of the relief of chest pain.
Previous studies sketchy
The results seem to also have Doctors convinced: “the results of The study will change our clinical Thinking,” said Alice Jacobs, a cardiologist at Boston University, the New York Times.
A long time is controversial whether Stent Implantation for patients with stable coronary heart disease compared to drug therapy is a better solution. In 2007 a study had not suggested that Stents are more effective than heart drugs. Then, only a debate on the proper use of Stents, however, was begun – the study was kept in by Doctors for non-coherent and the design of the study found to be incorrect.
Overall, the results of the ISCHEMIA study suggests that Stents and Bypass surgery should be used in patients with stable heart disease more economical. The decision to invasive procedure should also be less rushed. Patients with regular chest pain could give the invasive measures, however, relief.
Summary: American scientists have found that operations with stable coronary heart disease often superfluous: A comparison group, the only with medication therapy was, suffered not more likely to have a heart attack or died of the disease than those with the Stent-to-Deposit or a Bypass received. Only: – Invasive procedures can provide relief for chest pain which cannot be managed by medication alone. The study underlines previous study results, however, were questioned because of the study designs of the Doctors face.