Belated angioplasty saves no lives

From Chicago, at a meeting of the American Heart Association

A common heart procedure doesn’t save lives if it is performed more than a couple of days after a heart attack, according to a large international clinical trial.

The procedure, angioplasty, has been found to offer benefits when it’s done within 48 hours of a heart attack (SN: 6/25/05, p. 413: Available to subscribers at Heart attack treatment: Better late than never). In angioplasty, doctors force open a blocked heart artery by inserting and inflating a tiny balloon.

Nearly one-third of heart attack patients don’t realize what’s happening to them and so get no treatment within the 2-day timeframe, says Judith S. Hochman of New York University, who led the new study. In that group, doctors typically still administer drugs and often perform angioplasty once the heart attack is diagnosed. “Until this trial was completed, we didn’t know they were getting unnecessary [angioplasty] procedures,” Hochman says.

She and her colleagues studied 2,166 heart attack patients. All were given standard drug therapy, which usually includes administering aspirin and pills containing beta-blockers, during the period between 2 and 28 days, and on average 8 days, after the attack. The researchers then randomly selected half of the patients to receive angioplasty.

After 3 years, rates of death, recurrence of heart attack, and development of severe heart failure were not significantly different between the two groups, Hochman reported.