Heart Strategy: Angioplasty vs. Drugs
Study Shows Angioplasty May Prevent Second Heart Attacks in Symptom-Free Patients
May 8, 2007 -- Opening blocked arteries with angioplasty is more effective
than drugs for preventing second heart attacks in some heart attack survivors,
according to a 10-year follow-up study from Switzerland.
The newly reported study included 201 heart attack survivors with documented
heart vessel blockage but no chest pain or other symptoms. One group was
treated with angioplasty and drugs; the other group had intensive drug therapy
A decade later, 67 of the 105 drug-treated patients had suffered another
major cardiac event, compared with 27 of the 96 patients who had
Researchers say the findings show that later angioplasty is an important
preventive strategy for preventing second heart attacks in asymptomatic
The study appears in the May 8 issue of TheJournal of the
American Medical Association.
"We found a consistent benefit for this intervention in patients who did
not have chest pain or other symptoms [indicative of vessel blockage],"
researcher Paul Erne, MD, tells WebMD.
The New Findings
Though the patients in the study did not have chest pain or other symptoms,
they did have heart monitor abnormalities consistent with artery blockage
confirmed through exercise stress tests. Their heart attacks had occurred
within three months of enrolling in the trial.
All were treated with either angioplasty and drugs or intensive drug therapy
only between May 1991 and March 1997; follow-up continued until late May
None of the angioplasty patients had stenting; the procedure was not
standard practice at that time.
Patients in both arms of the trial took aspirin, cholesterol-lowering
statins, and blood pressure medications.
During an average of 10.2 years of follow-up, 64% of the patients treated
with drugs alone and 28% of those treated with angioplasty experienced major
cardiac events. Seven drug-treated patients and one angioplasty-treated patient
died of cardiac causes during the follow-up.
American Heart Association (AHA) spokesman Sidney C. Smith, MD, calls the
findings intriguing, but he tells WebMD that the study is far too small to
prove the value of angioplasty over drugs for asymptomatic heart patients.
He adds that major advances in both angioplasty and drug therapies for heart
disease in the 10 to 15 years since the patients in the study were treated
further complicate the interpretation of the findings.
Smith is director of the Center for Cardiovascular Science and Medicine at
the University of North Carolina, Chapel Hill and a past president of the
"A larger study comparing contemporary [drug] treatments to contemporary
angioplasty with stenting could tell us if these findings hold up," Smith