Angioplasty: Timing Is Key to Success
Study Shows Later Treatment May Not Help Some Heart Attack Patients
New Time Frame Recommended
The findings surprised the researchers, who went into the study thinking that opening up a blocked artery three to 28 days after the heart attack would cut the risk of death, development of severe heart failure, or another heart attack by 25%.
"It was logical that an open artery would be better than a closed one," Hochman says. "But sometimes logical doesn't prevail. And until this study was done, we didn't know this was an unnecessary procedure for the type of patient we studied."
Hochman says she hopes the findings will dissuade doctors from performing angioplasty outside the recommended time frame.
"It's certainly reason to rethink late angioplasty in stable patients after an acute heart attack," agrees Timothy Gardner, MD, medical director of the Center for Heart and Vascular Health at Christiana Care Health Services in Wilmington, Del., and chairman of the AHA committee that chose which studies to highlight at the meeting.
Angioplasty or Bypass Still Useful
The researchers emphasize that the findings only apply to the type of person studied: those whose heart attacks are caused by a blockage in one major artery and who are stable, with no chest pain when the angioplasty is performed three to 28 days later.
"If you have continuing chest pain or you have blockages in multiple arteries, you still need an intervention -- either angioplasty or bypass surgery," Gardner tells WebMD.
Additionally, angioplasty can still be lifesaving and relieve chest pain and other symptoms when performed within the 12-hour window, Hochman stresses. "That's why it is so critical to seek medical care very early after symptoms that could be a heart attack: chest discomfort, chest pressure or tightness, or even arm discomfort.
"Don't deny something is happening and sit home and take antacids," she says.