Stents and Bypass Surgery Help for Emergency Patients, But Not Stable Patients

November 8, 2020:

Here is an excerpt from an important new research study. The ISCHEMIA trial included people who had an abnormal stress test showing moderate to severe ischemia of the heart. Ischemia is when there is reduced blood flow to the heart due to narrowing caused by cholesterol deposits inside heart arteries. Reduced blood flow may cause chest pain symptoms, or “angina”.

ISCHEMIA compared two standard ways to treat ischemia to see if one was better at reducing the risk of heart attack or death, or improving symptoms.

1. One treatment method used medicines and lifestyle changes along with initial heart procedures consisting of cardiac catheterization followed by stent placement or surgery to improve blood flow, when feasible.
2. The other treatment method also used medicines and recommended lifestyle changes. Heart procedures were only used if symptoms could not be controlled with medication.

The ISCHEMIA trial showed that (for people with stable cardiac symptoms), heart procedures added to taking medicines and making lifestyle changes did not reduce the overall rate of heart attack or death compared with medicines and lifestyle changes alone. However, for people with chest pain symptoms, heart procedures improved symptoms better than medicines and lifestyle changes alone. The more symptomatic the patient is with chest pain to begin with, the more symptoms improved after getting a stent or bypass surgery.

These results apply to people with stable symptoms. They do not apply to people having a heart attack, when emergency stent procedures save lives.

You can read the full document at: https://www.ischemiatrial.org/ischemia-study-results-presented-aha-2019#ischemia