Christine Gorman
Propping open a clogged artery with angioplasty and a stent in the first few hours after a heart attack can mean the difference between life and death or between full recovery and severe disability. But about a third of patients who could benefit from such interventions don’t make it to the hospital within the first 12 hours of their heart attack, which is the optimal time for these procedures. Should doctors go ahead and do them anyway?
Until recently, most cardiologists thought the answer was yes. But a study of 2,166 men and women, published in the New England Journal of Medicine, has just concluded that placing stents more than three days after a heart attack began is not worthwhile and may actually do more harm than good.
This group of study subjects got to the hospital 24 hours or more after their heart attack began. They were then randomly assigned to either receive a stent, along with standard medications, or just the drugs alone. After four years of follow-up, investigators determined that the late placement of stents did not improve the patients’ chances of survival, nor did they have any fewer heart attacks than those who were on medical treatment alone. In fact, late stenting seemed to increase slightly the risk of having another heart attack in the future.
What it Means: Minutes matter when you’re suffering a heart attack. The faster you get to a good hospital that knows when to stent—and just as importantly when not to—the better off you’ll be.
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Until recently, most cardiologists thought the answer was yes. But a study of 2,166 men and women, published in the New England Journal of Medicine, has just concluded that placing stents more than three days after a heart attack began is not worthwhile and may actually do more harm than good.
This group of study subjects got to the hospital 24 hours or more after their heart attack began. They were then randomly assigned to either receive a stent, along with standard medications, or just the drugs alone. After four years of follow-up, investigators determined that the late placement of stents did not improve the patients’ chances of survival, nor did they have any fewer heart attacks than those who were on medical treatment alone. In fact, late stenting seemed to increase slightly the risk of having another heart attack in the future.
What it Means: Minutes matter when you’re suffering a heart attack. The faster you get to a good hospital that knows when to stent—and just as importantly when not to—the better off you’ll be.
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