To stent or not to stent...

Will patients and interventional cardiologists both be slow to embrace the new evidence on the value of drug therapy versus angioplasty? As reported in the Philadelphia Inquirer:

Studies have long shown that angioplasty can save a patient who is having a heart attack.

But the study released online Monday in the New England Journal of Medicine showed that patients who are not likely to have an immediate heart attack fared just as well with drug therapy.

The study found that more than half the patients who get angioplasties - more than a million each year - have heart disease that is stable and would do just as well under medication. The authors said the proportion of unnecessary angioplasties is as high as 85 percent - at a cost of about $30,000 to $40,000 per patient.

David L. Fischman, an interventional cardiologist and codirector of the cardiac-catheterization lab at Thomas Jefferson University Hospital, said patients and doctors should view angioplasty as a quality-of-life decision. The study found that half the 2,287 patients who received a stent had fewer symptoms, such as angina, at the onset. Those numbers narrowed as the study went on.

It will be interesting to see how the payors respond to these findings. Click here to read the entire article.