The Case for Clearing More Arteries During Heart Attacks
Under the current standard of care, doctors use a tiny balloon to open up the so-called culprit artery at the earliest possible moment in patients having STEMI heart attacks. That halts the attacks, protects heart muscle from damage, and often saves a lives.
Until now, doctors have believed that it doesn’t help to open up other partially blocked coronaries at the same time, says Dr. Laura Mauri of Brigham and Women’s Hospital in Boston, even though they can see other arteries are dangerously narrowed.
“Cardiologists have refrained from treating anything” but the total blockage causing the immediate heart attack, Mauri writes in a New England Journal of Medicine editorial that accompanies the British study. “They usually withhold further treatment unless a patient is symptomatic.”
The new study, which involved 465 patients with STEMI heart attacks in five U.K. hospitals, could very well change that. Its results were so strong that ethics monitors called an early halt to the trial in January.
The study authors say the results make clear that preventive unblocking of arteries narrowed by more than 50 percent “is a better strategy than restricting further intervention” to those suffering from recurrent chest pain or having a subsequent heart attack.
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