Basic Medication and Healthy Lifestyle As Good As Stents and Surgery in Stable Heart Disease Patients

For decades, medical science has relied on stents and bypass surgery to improve heart patient outcomes. It turns out, though, these common heart procedures—while effective—may not prevent heart attack or death from heart complications any better than cholesterol-lowering drugs and simple lifestyle changes; at least among Americans with stable heart disease. 

Cardiologists have relied on invasive procedures—like stents—to open clogged arteries.  Bypass surgeries, of course, have been used to reroute blood around similarly blocked arteries.  However, the latest ISCHEMIA study has revealed these procedures are not more effective at preventing heart-related deaths than medication and lifestyle changes. 

At the same time, it should be noted that the study also reported those with frequent angina—or chest pain—do experience more relief after stent implant or bypass surgery when co pared against medicine and lifestyle changes alone. 

Study leader Judith Hochman estimates that roughly 500,000 new patients every year are diagnosed with stable coronary artery disease.  The NYU Langone cardiologist further explains this condition is characterized by narrowing of the arteries due to fatty deposits, resulting in periodic angina, most often after emotional distress or exercise.

Again, the current guidelines recommend that patients who have severe narrowing of their arteries should undergo heart bypass surgery or have a stent implanted.  Hochman notes, however, “There’s always been a fear that if you don’t do something quickly, they will have a heart attack or drop dead.  For those with mild or no chest pain, there’s really not a role for immediately stenting.”

But there is more to this than health outcomes for patients.  Eliminating unnecessary stenting procedures could potentially save the US healthcare system upwards of $570 million every year.  In fact, Stanford University School of Medicine cardiologist—and study co-author—David Maron estimates the cost per stent procedure, in the United States, typically costs around $25,000; a bypass surgery procedure typically costs around $45,000. 

According to the American Heart Association, approximately 17 million people have stable heart disease, with 9.4 million experiencing periodic chest pain.  Doing the math it is easy to see how much money and time could be saved. 

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