The Angioplasty Scam There Are Better, Cheaper Alternatives

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At the European Association of Cardiovascular Prevention and Rehabilitation meeting recently held in Barcelona, Spain, new heart research was presented that shows one treatment in particular can provide remarkable help for patients with certain forms of serious heart disease. It’s not a new drug or surgical procedure. Instead, it’s a natural therapy – plain old-fashioned regular exercise.

In fact, in several studies just presented at the meeting, exercise reduced the markers of heart disease in patients following coronary artery bypass surgery (CABG). What’s more, it improved indications of disease in people with heart failure, a condition usually thought to be incurable and often just treated with symptom-relieving drugs. But the news that’s perhaps most likely to make some interventional cardiologists’ hearts skip a beat or two was the evidence presented that showed that exercise improved cardiac event-free survival in coronary patients better than angioplasty with stents.

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Also called percutaneous coronary intervention (PCI), angioplasty is commonly used to help people with coronary artery disease whose arteries are narrowed and even blocked by a build-up of sticky plaque. By threading a thin tube through a blood vessel in the arm or groin, interventional cardiologists perform angioplasty to restore blood flood through a clogged artery. A tiny balloon at the end of the tube is inflated when it reaches the exact spot of blockage. That pushes the plaque outward against the walls of the artery, restoring blood flow. A small metal device called a stent is also carried by the tube and deployed at the site of the blockage in order to prop open the artery.

This approach to treating heart disease is a huge business. A report in Bloomberg News last fall noted that about 800,000 angioplasties are performed each year in the U.S. at a cost of about $10 billion annually. And, although many cardiologists consider angioplasty to be the “gold standard” of care in most types of acute coronary events such as heart attack, the procedure’s long term benefits have been questioned by many doctors. In addition, the role of angioplasty in treating other kinds of coronary disease, like angina, isn’t clear.

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July 13, 2009