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publicado em 03/09/2013 às 13h00:00
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New form of surgery reduces risk of death after heart attack

Surgery, known as angioplasty preventive chance of serious complications decreases by two-thirds

 
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A new form of surgery for heart attack patients could save thousands of lives a year, research shows.

The procedure, known as preventative angioplasty, has been shown to cut the risk of death and other serious complications by two thirds.

British doctors behind the research believe the surgery, which treats other blocked arteries as well as the one that triggered the attack, should be adopted routinely because it could save millions of pounds.

Heart attacks occur when one of the coronary arteries blood vessels that supply blood to the heart becomes blocked, causing the muscle to become damaged.

At present, patients undergo an emergency operation called an angioplasty immediately after the attack when doctors insert a thin tube a stent into the blocked artery to allow blood to flow through.

During surgery they often discover that other arteries are partly blocked, which could cause another heart attack in the future.

Although NHS guidelines tell doctors to treat only the artery which caused the attack, some experts have been inserting stents into other high-risk vessels in the hope of preventing future problems.

Because each procedure can trigger bleeding, strokes or another heart attack, and incurs an extra cost, many doctors do not believe it is worth it.

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But until now, there has been no evidence as to whether it worked or saved lives.

Dr David Wald from Barts and the London NHS trust carried out a study on 465 patients who had suffered heart attacks between 2008 and 2013.

They were treated at specialist heart centres in hospitals in the UK including the London Chest, Norfolk and Norwich, Newcastle and Glasgow. Around half of patients had surgery to insert a stent only on the artery which had caused the heart attack, while half had the device implanted in other blocked arteries as well.

The research, published in the New England Journal of Medicine, showed that patients who had surgery on other blocked arteries were 64 per cent less likely to die or suffer another serious heart attack.

Dr Wald, who presented the findings at the European Society of Cardiology conference in Amsterdam, said: 'The trial provides new evidence which may help review the existing guidelines. Obviously it will always be up to the individual doctor to look at the patient and decide themselves. For me, as a cardiologist, it has completely changed the way I practice.

'There will be an initial cost because of the extra stents and the additional time. But these will probably be more than offset by the future savings in terms of admissions to hospital and other complications.'

It costs the NHS around £700 to carry out the procedure on one artery, which includes general aesthetic, so having additional blood vessels repaired at the same time will not be significantly more expensive.

Peter Weissberg, of the British Heart Foundation, said: 'The establishment of heart attack centres that immediately open blocked coronary arteries in heart attack patients has led to much better survival rate.

'This important study suggests even better outcomes may be achievable.'

Source: Isaude.net
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