Are Stents and Bypass Surgery The Best Way to Treat Narrowing Coronary Arteries?

Commentary By Dr. Bradley B. Hill

The following article, published in the Wall Street Journal, describes how patients can reduce their chances of a heart attack or stroke. Maintaining a healthy diet (less meat and more fruits and vegetables), exercising at least 30 minutes a day (extra walking counts), not smoking, actively managing stress, and taking appropriate medications in the correct doses are sure ways to boost your quality of life. Looking back on my 20 years of vascular surgical practice and the many thousands of arterial procedures I’ve performed, most of the procedures could have been avoided if my patients had taken to heart the above measures early in their lives. Even in one’s later years, adopting these lifestyle changes can slow or even halt the progression of cardiovascular disease. You can’t change your genetic makeup but you can make healthy lifestyle choices every day. 

Study Finds Limited Benefits of Stent Use for Millions With Heart Disease

By Betsy McKay

November 16, 2019, 5:44 p.m. EST

PHILADELPHIA—Stents and coronary artery bypass surgery are no more effective than intensive drug treatment and better health habits in preventing millions of Americans from heart attacks and death, a large study found, shedding new light on a major controversy in cardiology.

Researchers and doctors have fiercely debated for years how best to treat people who have narrowed coronary arteries but aren’t suffering acute symptoms.

The standard treatment has been to implant stents—wire mesh tubes that open up clogged arteries—or to perform bypass surgery, redirecting blood around a blockage. Those procedures are performed even though these patients either have no symptoms or feel chest pain only when they climb a few flights of stairs or exert themselves in some other way.

The study is the largest and among the most rigorous research yet to suggest that while stents and bypass surgery can be lifesaving for people who are having heart attacks, they aren’t necessarily better than cholesterol-lowering drugs and other changes in health habits for most people with chronic, or stable, coronary artery disease, which affects about 9.4 million Americans.

“You won’t prolong life,” said Judith Hochman, chair of the study and senior associate dean for clinical sciences at the New York University Grossman School of Medicine.

But stents or bypass surgery work better than medicine and lifestyle changes alone in relieving symptoms for people who have frequent angina, or chest pain, the researchers found.

The findings, released Saturday at the American Heart Association’s annual scientific conference, should prompt more discussion between patients and their doctors about treatment, she said. “Statins and aspirin are critically important,” she said. “We need to understand better how to get people to modify their risk factors.” Lifestyle changes can be hard to make and sustain, she said.

You can read the full article here.