Patients whose heart artery shrinks but if they do not always complain of severe chest pain, then such patients do not need invasive therapy. Such patients can be healthy only with simple medical therapy. This has been confirmed in a major study named ISCHEMIA Trial involving 5000 Heart Patients. The results of this study were released at the annual meeting of the American Heart Association.
There are 4.5 lakh angioplasties annually ,about 4 and a half lakh patients have angioplasty in India every year and a large number of patients also undergo bypass surgery to treat blocked artery. According to Dr. Ambuj Roy, Professor of Cardiology, Delhi-based AIIMS, one-third of angioplasty and heart surgeries that occur every year are those with very severe symptoms, with Ischemic Heart Disease (IHD) stable. The ISCHEMIA Trial shows that such patients do not require surgery and do better than medical therapy. IHD is a heart problem in which the heart artery, the artery of the heart, is narrowed, which ultimately leads to heart attack.
The study included 5,179 patients The ISCHEMIA Trial, which started in July 2012, included researchers from top medical institutes around the world and selected 5 thousand 179 patients with stable IHD for the study. These patients had never had a heart attack and there was no blockage of any kind in their left main coronary artery. Most patients had compressed arteries problem, which was revealed during the exercise stress test.
One group received only medicines and the other group underwent surgery
Out of these 5000, 2591 patients were given the usual medical therapy which included blood thinning drug, cholesterol lowering drug and heartbeat slowing drug. The remaining 2588 patients either underwent angioplasty or bypass surgery. Most people would be thinking that putting a stent through angioplasty or removing blockages through bypass surgery will reduce the risk of heart attack compared to medicines. But nothing like this happened. In the followup that lasted for about 3 years and 3 months, the researchers did not see any significant difference between the two groups.
After 3.3 years, there was no difference between the patients of the two groups,
13.3 percent of the patients who underwent surgery after 3.3 years showed overall complications, while 15.5 percent of patients who underwent medical therapy showed complications. Dr. Ashok Seth, chairman of the Fortis Escorts Heart Institute, says angioplasty is being performed more often these days. If a patient is having a chronic but stable chest pain, then such a patient does not need to undergo an angioplasty in emergency. Fear of advanced drug therapy may also improve the condition of such patients. Only those patients who have severe symptoms of the disease and in whom chest pains are very and long-term need surgery.
Lifestyle needs change
There are 4 to 5 crore patients in India who are suffering from IHD ie problem of compressed heart artery. According to studies, about 15 to 20 percent of patients die due to this disease. In such a situation, patients need to make a lot of changes in their lifestyle. Cardiologists suggest to eat healthy food, have regular physical activity, stay away from cigarette-alcohol.
