A comprehensive study has demonstrated that the efficacy of invasive treatments—such as the installation of stents or the performance of angioplasties—is not necessarily better than that of medicinal and lifestyle-based management strategies.
The $100 million study, funded by the United States government, looked at 5,179 participants and spanned 37 countries. It was twice as large as previous studies and presents the most rigorous evidence yet that invasive techniques are no better than drug treatments or healthier lifestyle-changes.
While invasive treatments can alleviate the symptoms, they do not necessarily reduce the risk of death or of a heart attack, according to the study. Cholesterol-lowering drugs may be as effective as techniques like stents and bypass surgeries.
In some cases, patients who underwent invasive techniques were more likely to suffer a heart attack or even die.
It must be noted that stents and bypass surgeries are still necessary and potentially life-saving for those who have suffered from a heart attack and that this study concerns only those who have stable angina (chest pain) issues. In the study, invasive techniques performed better at alleviating symptoms than medicinal or lifestyle-related strategies alone.
Chaired by Dr Judith Hochman, The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial had several universities as collaborators including NYU, Stanford, Columbia, Duke, Emory, Harvard and others.
According to Hochman, at least half a billion dollars a year could be saved by “not doing procedures based on the results of the study”.
