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"George W Bush’s recent decision to consent—in the absence of symptoms—to the implantation of a stent by an interventional cardiologist has led to an entirely justifiable debate on how best to treat stable coronary artery disease. Though the clinical benefit of percutaneous coronary intervention (PCI) in managing acute coronary syndromes has been proved,1 2 3 4 many robust randomised studies (which included patients at low and at high risk) have not shown any prognostic value in stenting for stable angina in addition to optimal medical therapy.5
Given the complications related to the procedure, the fact that many serious events result from non-significant lesions,6 the potentially thrombotic milieu created by a metal scaffold apposed to the intima of a coronary artery after it is stretched by a balloon, and the potency of lifestyle interventions and pharmacotherapy, it is perhaps easier to understand that even stenting a 90% stenosed artery for stable angina does not prevent heart attacks or prolong life. Yet such practice continues to contribute to overspending in healthcare in the United States, whose total healthcare spending is predicted to …"
From Aseem Malhotra in the BMJ here http://www.bmj.com/content/347/bmj.f5741
I have nothing but praise for Dr. Aseem Malhotra, a true star in the fight against dietary lunacy, but I beg to differ with him on the above. He may well be right when he says "that even stenting a 90% stenosed artery for stable angina does not prevent heart attacks or prolong life" but in terms of quality of life the benefits are immeasurable in my opinion.
Back in June 2009 I had angioplasty and two stents fitted. I was suffering from 90% proximal stenosis of of the LAD and 95% stenosis of the distal RCA. I had a resting heart rate of 120 beats per minute, BP through the roof and a short walk was becoming unbearable. Two flights of stairs and I could hardly breath, in short I was on the way out. I had the procedure on a Friday and sent home that day. On the Monday following I gave my pump a work out, on the stairs that very near croaked me. I run up and down with a 50 lb camera flight case in each hand. In short I was 20 years younger almost overnight.
Now, I might not live one day longer and may well go down with a massive heart attack (that's cool with me) but the quality of my life was massively improved. Without angioplasty and heart stents it would be a complete miracle to still be alive today, no one could ever convince me otherwise. The bottom line, it's the quality of life that counts, not the length of life, and I will be ever grateful for the geniuses at the University Hospital Southampton, they gave me a life worth living back.
Given the complications related to the procedure, the fact that many serious events result from non-significant lesions,6 the potentially thrombotic milieu created by a metal scaffold apposed to the intima of a coronary artery after it is stretched by a balloon, and the potency of lifestyle interventions and pharmacotherapy, it is perhaps easier to understand that even stenting a 90% stenosed artery for stable angina does not prevent heart attacks or prolong life. Yet such practice continues to contribute to overspending in healthcare in the United States, whose total healthcare spending is predicted to …"
From Aseem Malhotra in the BMJ here http://www.bmj.com/content/347/bmj.f5741
I have nothing but praise for Dr. Aseem Malhotra, a true star in the fight against dietary lunacy, but I beg to differ with him on the above. He may well be right when he says "that even stenting a 90% stenosed artery for stable angina does not prevent heart attacks or prolong life" but in terms of quality of life the benefits are immeasurable in my opinion.
Back in June 2009 I had angioplasty and two stents fitted. I was suffering from 90% proximal stenosis of of the LAD and 95% stenosis of the distal RCA. I had a resting heart rate of 120 beats per minute, BP through the roof and a short walk was becoming unbearable. Two flights of stairs and I could hardly breath, in short I was on the way out. I had the procedure on a Friday and sent home that day. On the Monday following I gave my pump a work out, on the stairs that very near croaked me. I run up and down with a 50 lb camera flight case in each hand. In short I was 20 years younger almost overnight.
Now, I might not live one day longer and may well go down with a massive heart attack (that's cool with me) but the quality of my life was massively improved. Without angioplasty and heart stents it would be a complete miracle to still be alive today, no one could ever convince me otherwise. The bottom line, it's the quality of life that counts, not the length of life, and I will be ever grateful for the geniuses at the University Hospital Southampton, they gave me a life worth living back.
