The People's Perspective on Medicine

Cardiac Care Puzzle: Speedier Stents Did Not Result in Better Heart Attack Survival Rates

Over the last few years hospitals have made substantial improvements in getting heart attacks patients from the ER to the cath lab quickly so they can get emergency angioplasty in a timely fashion. In this procedure a cathether is threaded from the femoral artery into the heart to the site of the blockage. A balloon is inflated and a stent inserted to reopen the clogged coronary artery.

A study in The New England Journal of Medicine reports that despite a significant decrease in door to balloon times, heart attack patients have not reaped the expected survival advantage. Researchers are not clear what metrics would make more of a difference in reducing heart attack mortality. There is more information about this study here.

[New England Journal of Medicine, Sept. 4, 2013]

For those who do survive their heart attacks, the evidence has become even stronger that adopting a healthy lifestyle, such as a diet rich in vegetablesand a practice of regular exercise, will help people live longer. Last year we interviewed Steve Nissen, MD, chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic, about Keeping Your Heart Healthy. It is full of useful information for people working to keep their hearts healthy.

 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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When I read the full report about stents and angioplasties not improving the later risk of heart attack I ruminated. I have several friends with stents and who have had angioplasties. They are doing better in that they now can be more active and have less episodes of chest pain. So I asked myself, what could be making the difference.
One friend, in particular, who is so extraordinarily and healthy at 84 years of age had a stent put in after caring for her dying husband for over a year and going through the loss of him. She was exhausted and had not slept good most of that time. Could the thing that actually helped her been the prolonged rest she got after the stent rather than the stent itself? I wonder. Other friends who have had this kind of intervention have also been forced to slow down and rest for a month or more. Some of them begin eating better.
Could the improvement be the rest and removal of extra stress that this slow-down brings? Maybe… I know this, if I received a prognosis that these circulatory interventions are necessary, I would consider that a prescription to make a serious change to the Mediterranean Diet and seek out physical rehab in order to improve my overall health; and to seriously rearrange a few stresses in my life.

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