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No benefit to mechanically opening arteries days after a heart attack

d expected that angioplasty to open arteries would reduce the risk of subsequent clinical events, specifically heart failure and death in this population that was stable after the initial heart attack but at increased risk of events in the future," said Dr. Hochman, who is also the Clinical Chief of the Leon H. Charney Division of Cardiology and the Harold Snyder Family Professor of Cardiology at NYU School of Medicine. "We thought it was possible that the risk of a recurrent heart attack would also be reduced. The results were surprising and do warrant a major change in practice."

"Angioplasty has been proven to improve symptoms in patients with angina and to prolong life in patients early after a heart attack," said Dr. Hochman. "This study shows that angioplasty provides no benefit in these patients with a total blockage and no or mild symptoms late after a heart attack. Patients should know whether a procedure is being performed to treat symptoms or whether there is evidence that they will live longer or have a lower likelihood of heart attack or heart failure," she said.

Interventional cardiologists use miniature devices that clear clogged arteries and restore blood flow to the heart to treat heart attack patients. In the study, doctors employed balloon angioplasty, which flattens plaque against the walls of blood vessels by inflating a tiny balloon tethered to the tip of a catheter. Tiny wire tubes called stents were inserted then into the artery to keep the vessel open. The vast majority of the patients who were treated with the balloon procedure had stents implanted at the same time.

"It is critical that patients present immediately after the onset of symptoms of a heart attack," said Dr. Hochman. "If they miss the reperfusion treatment window, they should receive optimal medication therapy. Medical therapy has improved dramatically and those patients did quiet well and better than projected."

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Contact: Jennifer Choi
jennifer.choi@nyumc.org
212-404-3555
New York University Medical Center and School of Medicine
14-Nov-2006


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