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Angioplasty for silent heart attacks

‘Silent’ heart attacks are best treated with angioplasty rather than with medications.

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Following a heart attack, many patients continue to have low blood flow to the heart tissue, yet have no symptoms. These 'silent' heart attacks are best treated with angioplasty rather than with medications.In angioplasty, a tiny catheter is inserted in an artery in the leg or arm, and the tip is extended into the coronary arteries supplying blood to the heart, under x-ray guidance. A tiny balloon at the tip of the catheter is then inflated, which opens the blocked artery, ideally restoring blood flow to the heart tissue. Angioplasty is often accompanied by the placement of a stent to keep the narrowed artery open. Swiss researchers from Kantonsspital Luzern did a study comparing angioplasty to drug therapy in 201 patients with asymptomatic reductions in coronary blood flow following a heart attack. During an average follow-up period of 10 years, it was found that the drug therapy group experienced a total of 67 major heart-related events, such as death due to heart attack and the need for repeat angioplasty or heart surgery. In contrast, just 27 events were seen in the angioplasty group, which translated into a 64 percent reduced risk of these events. Moreover, heart function in the angioplasty group improved slightly during the study period, whereas it worsened markedly in the drug therapy group. Therefore, the researchers found a persistent benefit of angioplasty compared with optimised drug therapy.
Journal of the American Medical Association,
May 2007

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