Heart Stents Fail to Relieve Chest Pain for Many
A new study that many cardiologists call stunning suggests that arterial stents – tiny wire cages used for decades to open blocked arteries – do not actually relieve chest pain as expected. Worldwide, hundreds of thousands of patients undergo stenting procedures each year, and this research indicates the procedure may be useless for many of them.
The study was conducted by researchers at Imperial College London. It involved 200 patients with significant coronary artery blockage and severe chest pain that limited physical activity, common reasons to undergo a stenting procedure. Study participants were treated for six weeks with medications to reduce heart attack risk and relieve chest pain and then underwent cardiac catheterization with either a real or a sham stent insertion – once the catheter reached the blockage, the doctor inserted a stent or simply removed the catheter. Neither the patients nor the researchers knew which of the study participants had received a stent. Both groups were then put on medications to prevent blood clots.
After six weeks, both groups reported less chest pain and did better on exercise stress tests. However, researchers discovered no real difference between the patients. Those who got the sham procedure did just as well as those who got stents. One reason for this could be that atherosclerosis affects several blood vessels and stenting only the largest blockage may not make much difference in a patient’s pain level. Another might be due to the placebo effect. Results of the study, which have some cardiologists calling for revised guidelines for arterial stenting, were published in The Lancet.