The most important reason for patients to have a cardiac stent placed is to unblock an artery if they are having a heart attack. Cardiac stents are also commonly used to relieve symptoms of chest pain during exertion in patients who have narrowed (but not blocked) heart arteries.
A groundbreaking medical study was just published in “Lancet” that is now going to change the way cardiologists determine who really needs a cardiac stent. The study is called ORBITA and it found that patients who had chest pain from a severely blocked heart artery (but were not having a heart attack) did not do any better after placing a cardiac stent than those who were instead treated aggressively with only medication and lifestyle changes. So that means patients with stable angina can manage their symptoms simply by adjusting their heart medication and without placing a cardiac stent. WOW!
These are the downsides of having a cardiac stent placed:
1. an allergic reaction to medications or dyes used in the procedure
2. breathing problems due to anesthesia
3. excessive bleeding
4. a blockage of the artery
5. blood clots
6. a heart attack
7. an infection of the blood vessel or at the insertion site of the catheter
8. kidney failure from the contrast dye
9. a re-narrowing of the artery
10. a hefty out-of-pocket payment for the procedure
11. an overnight hospital stay
12. commitment to a blood thinner for a year
13. death from a complication during the procedure
Stents and their placement also cost from $11,000 to $41,000 at hospitals in the United States. Even though medications can also be expensive, the cost of a stent placement far exceeds the cost of the medication.
Physicians are constantly studying, testing and researching medical treatments and procedures – doctors always want to do what’s best for their patients. Cardiologists treat very sick patients who also may appear to be healthy but may be on the verge of having a heart attack. The medical community will be scrutinizing this study and utilizing the results as they see fit to provide the best possible care for their patients.
As an mdvip primary care doctor, my appointment times are 60 minutes long. It’s not unusual for my patients to discuss procedures and treatments that specialists have recommended. Most of their concerns are due to the fact that they didn’t have a good understanding of what was being done because office visits have become shorter and there isn’t time to properly answer questions. I always act as a patient advocate to help facilitate care they need or to intercede if there needs to be more discussion with a specialist before moving forward.
Heart disease kills 1 in 3 Americans. I’m anticipating spending a lot of time discussing the results of ORBITA with my cardiac patients as well as providing education on how lifestyle changes can improve their cardiac disease with healthier eating and more activity.