Angioplasties are routinely performed on heart attack patients days and even weeks following a heart attack, and involve inserting a tiny balloon into a blocked artery and inflating it to clear blockages. However, the researchers' study found that waiting to perform an angioplasty could actually harm heart attack patients by possibly increasing their chances of a second attack or heart failure.
The researchers, led by Judith Hochman of the NYU School of Medicine, examined nearly 2,200 patients from 27 countries who received treatment for heart attack. The patients were treated three to 28 days following their attack, and some received angioplasties while others received only drug treatments.
Hochman and colleagues found that the patients who received angioplasties experienced no significant benefits compared to patients who received drug treatment only. The researchers examined the patients' chances of having a second heart attack or heart failure, as well as death rates, and found that those who underwent angioplasty surgery were more likely to have another heart attack.
The researchers -- whose study was published in the online edition of the New England Journal of Medicine and presented at a recent meeting of the American Heart Association in Chicago -- believe that the act of reopening a large clogged artery during an angioplasty could cause smaller vessels to close, rendering them unavailable if the larger artery becomes blocked again.
"These results challenge the long-standing belief that opening a blocked artery is always good," said Elizabeth G. Nabel of the National Heart, Lung, and Blood Institute, which provided funding for the study. "Instead, the study suggests that late angioplasty is unnecessary in this circumstance."