Heart disease patients who experience regular bouts of chest pain — those are not emergency situations like heart attacks — often are faced with deciding whether to have angioplasty along with a stent to prop open their blocked artery and reduce symptoms or to stick with just medications such as beta blockers and a cholesterol-lowering statin. But a study published online last week by the New England Journal of Medicine may help make the decision easier for doctors and patients.
It found that those who had a minimally-invasive test called fractional flow reserve to measure blood flow in the blocked artery had a better outcome from stenting with medications than when they chose medications alone, if the test revealed that the artery was not functioning properly and that the blockage might eventually lead to a heart attack.
About 4 percent of patients who had stents placed based on their poor results on the fractional flow reserve test wound up having a heart attack or being hospitalized to have an emergency angioplasty with stent placement, compared with nearly 13 percent of those with a poor result on the test who were randomly selected to remain just on their medications.
Whether the results lead to an increase in stent procedures — which have been on the decline ever since studies found that they don’t decrease death risk in stable heart patients — remains to be seen.