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Video: Taking Medications And A Healthy Lifestyle Prevent Heart Attacks As Well As Surgery
Taking medications and a healthy lifestyle prevent heart attacks as well as surgery
In patients with stable coronary artery disease, regular medication and a healthy lifestyle can prevent heart attacks and death from heart disease as effectively as surgery.
Photo: CC0 / 2044
According to the largest American study presented at the conference of the American Heart Association in Philadelphia, in patients with stable coronary artery disease, regular medication and a healthy lifestyle prevent heart attacks and death from heart disease as effectively as surgery. Unlike myocardial infarction, which immediately requires a procedure to restore blood flow, in cases that do not require emergency intervention, "there is no need to rush."
When the arteries are blocked, the blood supply to the heart is limited, which can cause recurrent chest pain. Taking aspirin, drugs to lower cholesterol, and blood pressure reduce the risk of myocardial infarction for these people. But current guidelines recommend that patients with significant arterial narrowing undergo heart bypass surgery or stent implantation.
Scientists have come to the conclusion that it is necessary to use less often stenting (the installation of a special frame that widens the artery at the site of narrowing) or shunting (creating a new flow of arterial blood bypassing the affected area of the vessel using the patient's own vein or artery).
Study leader Judith Hochman emphasized that the findings do not apply to all patients with heart disease: “For those with mild or no chest pain, immediate stenting will not play any role … But in myocardial infarction, stents save life ".
A large study back in 2007 showed that stenting is no more effective than medication in preventing heart attacks and death in non-emergent patients. The results received widespread criticism, prompting a new study, about twice the size of the original.
The study covered 37 countries and included 5179 participants with moderate to severe but stable ischemia, a condition in which blood supply is impaired due to partial blockage of the arteries.
Half of the participants received only heart medications and lifestyle advice over a four-year period, while the other half underwent surgery in addition to medication.
The doctors then tracked how many cases of myocardial infarction, death from cardiovascular causes, cardiac arrest, hospitalization due to worsening chest pain or heart failure in each group. One year later, 7% of those operated on experienced one of these events, compared with 5% of those taking medication alone. Four years later, the trend changed - 13% versus 15%. On average, over the entire study period, the indicators were the same regardless of treatment. In terms of reducing chest pain in the operated patients, the indicators were better - 50% versus 20%, but the researchers do not exclude the influence of the placebo effect on the results.
If invasive procedures did not carry their own risks, “I think the results would show their overall benefit. But that's not what we found. We found early harm and then benefit, and they mutually annihilated,”said David Maron, co-leader of the study.
Experts explain the high efficiency of drug therapy in reducing risks by the fact that shunts and stents fix only a small area, while drugs affect all arteries. Moreover, medications have improved significantly in recent years.
Scientists will continue to monitor all patients over the next five years to get an even more accurate picture.
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