Following on a trend noted in previous posts here and here, this NY Times article (see also here) reports that findings from a major new study suggest that noninvasive treatment with beta-blockers and other heart drugs turns out to be at least as good as angioplasty for patients whose arteries remain blocked at least three days after a heart attack. The findings — which were presented earlier this week at the annual scientific meeting of the American Heart Association and published simultaneously online by the New England Journal of Medicine — supplement an increasing body of research that is indicating that heart-attack patients whose disease is stable and whose symptoms are under control should be wary of taking the risk of invasive treatment, which can result in infection and bleeding.
Over the past 20 years or so, treatment of heart attacks has been transformed by the ability of doctors to break up blood clots that cause the heart attacks with clot-busting drugs and angioplasty procedures. By quickly restoring blood flow to the heart muscle following an attack, doctors have been able to save lives and minimize damage that can lead to total heart failure. However, a nagging problem has been that about a third of the million or so Amerians who suffer a heart attack each year do not arrive at a hospital within the 12-hour window after the attack during which the patients are most likely to benefit from these techniques. In those patients who stabilize on their own after an attack and then are not diagnosed with blocked arteries until days after the attack, the conventional wisdom has been to go ahead and perform the angioplasty, anyway.

Continue reading →