Doing Angioplasty Long After Heart Attack Still Worth It, Anal...(w-up period presents problems since it i...),Health

Date:2/25/2008

w-up period presents problems, since it includes procedures done a decade or more ago, Hochman noted. "Medical therapy 10 years ago was primitive," she said. "we didn't use high-dose statins. Some of the studies included began almost 20 years ago. So, is it relevant to look at studies that began 20 years ago and didn't use current optimum [medical] therapy?"

Statins are cholesterol-lowering drugs that are now widely prescribed for coronary problems.

The new meta-analysis is imperfect, Abbate acknowledged. "I'm not saying that it is the last word, but it helps us put things in perspective," he said. The study indicates that "if you take the entire group of patients after myocardial infarction [heart attack] who do not get revascularization within 12 hours, some groups will have a greater benefit from later revascularization," Abbate said.

The report does not invalidate the current guidelines of the American Heart Association and the American College of Cardiology, which recommend angioplasty within 12 hours of a heart attack and limit later use of the procedure to specific indications, Hochman said. The guidelines for a later angioplasty include cases where there is severe blockage of arteries, with severe symptoms, and where the left main coronary artery is affected, she said.

"The list of those who want mechanical intervention is not changed by this study," Hochman said.

More information

What angioplasty is and why it is done is explained by the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Antonio Abbate, M.D., assistant professor, medicine, Virginia Commonwealth University, Richmond; Judith Hochman, Harold Snyder Family professor of cardiology, New York University, New York City; March 4, 2008, Journal of the American College of Cardiology

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