Studies question heart procedures

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Associated Press

NEW ORLEANS

Two new studies could change care for hundreds of thousands of heart patients each year. One finds that bypass surgery has been overrated for many people with very weak hearts from clogged arteries and previous heart attacks. The other challenges the way artery-opening procedures have been done for decades.

It was the first big test of doing balloon angioplasty to clear heart arteries through an arm instead of a leg. Complications were fewer with the arm method, and at hospitals that did this more often, deaths, heart attacks and other big problems were lower, too.

The arm method is common in India, Israel, Europe and Canada, but less than 5 percent of U.S. cases are done this way.

The studies were presented Monday at the American College of Cardiology conference in New Orleans.

The bypass study showed the operation did not improve survival for heart-failure patients who already were taking medicines to control risks such as high cholesterol and high blood pressure.

The study involved 1,200 heart-failure patients in 22 countries, mostly men around 60 years old. Most had suffered a heart attack in the past. All were taking medicines they should for heart risks, and half were assigned to get bypass surgery also.

Doctors assumed bypass would cut deaths by 25 percent. But after nearly five years, about the same number in each group had died, said study leader Dr. Eric Velazquez of Duke University Medical Center.

The other study involved more than 7,000 people in 32 countries getting an angiogram — a diagnostic test to look for blockages — followed by angioplasty to open any clogs found.

It usually involves poking a tube through a leg artery near the groin up to the heart, inflating a tiny balloon to flatten a blockage in a heart artery and placing a mesh tube called a stent to prop the artery open. But patients can suffer major bleeding requiring transfusions or surgery, so doctors are trying this through an artery in the wrist instead.

The study assigned patients to get one method or the other. Survival and success rates were similar — about 4 percent of each group died or had a heart attack, stroke or major bleeding in the following month.

But significantly fewer of these problems occurred in people treated with the arm method after major heart attacks.