You don't need a stent, you just need the drugs?

You don’t need a stent, you just need the drugs?

You probably heard the big medical news last week: A major study published in the New England Journal of Medicine showed that heart patients who had stents implanted in arteries were no more or less likely to suffer heart attacks or premature death compared to heart patients who took a mix of drugs that included blood thinners and cholesterol-lowering statins.

Now here’s what you didn’t hear

This was not a straight up comparison, pitting stents vs. drugs. ALL subjects took the mix of drug therapy.

According to the New York Times, the subjects in this trial had “a relatively stable form of coronary artery disease that generally progresses slowly.” Patients in this group are not considered to be in immediate danger of a heart attack.

Even though subjects in the stent-plus-drugs group had about the same rate of heart attacks or premature death, they did experience better blood flow to the heart compared to the drugs-only group.

And here’s my favorite hidden detail: Over the course of the study (the follow-up period lasted an average of about four and a half years) nearly one-third of the subjects in the drugs-only group needed bypass surgery or stents to address worsening symptoms. Nevertheless, most of the media reports of this study (especially TV news reports) sounded like commercials for heart drugs – most notably statins. The primary “take away” message was: You don’t need a stent, you just need the drugs!

Oh – and one more thing you probably didn’t hear reported: Eight drug companies provided funding for the study.

Don’t get me wrong – I’m not singing the praises of stents here. I just want to make sure you can hear the facts over the chorus of “Are you taking enough heart drugs?” For a closer look at stent problems, read the e-Alert “Clear and Present Danger,” at: http://www.hsionline.com/ealerts/ea200701/ea20070109a.html

Sources:
“Optimal Medical Therapy With or Without PCI for Stable Coronary Disease” New England Journal of Medicine, Published online ahead of print 3/26/07, content.nejm.org
“In Trial, Drugs Equal Benefits of Artery Stents” Barnaby J. Feder, The New York Times, 3/27/07, nytimes.com