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Is Less More for Heart Attack Patients?

There's new evidence out today that more is not always better when it comes to treating heart attack patients.

About 1 million Americans each year suffer heart attacks, which occur when arteries supplying blood to the heart get blocked. Those who get to the hospital right away can often be saved if doctors can reopen those arteries immediately. But about a third of patients do not get medical care for more than 12 hours after their first symptoms appear. At that point, it's been unclear what's the best treatment.

Two years ago, a study involving more than 2,100 heart attack patients compared the outcomes of two approaches. About half the patients simply took aspirin and other medicines to lower blood pressure and cholesterol and prevent clots; the other half did the same and also underwent a procedure known as an angioplasty, which involves snaking a tiny balloon to the blocked area, inflating it to reopen the artery and leaving a tiny metal lattice tube known as a stent behind to keep the passageway open. The study surprised many doctors by showing that patients who got drug therapy alone appeared to do just did as well as those who got stents.

In a new analysis published in today's issue of The New England Journal fo Medicine, Daniel Mark of Duke University of his colleagues examined 951 patients in the original study who were followed for a longer period of time. About half got drug therapy alone.

The researchers found that after four months the patients who got angioplasty reported less chest pain and scored higher on a scale that measured quality of life, such as pain, physical limitations, a sense of vitality and ability to function. But those differences disappeared over time and after two years the patients who received drugs alone appeared to be doing just as well. In addition, their medical bills were about $7,000 lower.

The study is part of a growing body of evidence that suggests that more isn't necessarily always better. In fact, the opposite is often true. And maybe it doesn't hurt to have an aspirin handy in case you need one.

By Rob Stein  |  February 19, 2009; 7:00 AM ET
Categories:  General Health  
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It's hard to believe that the difference in cost was ONLY $7,000.

Posted by: RedBird27 | February 19, 2009 11:41 AM | Report abuse

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