Heart treatment uncertainty ‘risks lives’

Uncertainty over which treatment is most suitable for patients with heart disease could lead to thousands being denied the best chance of survival, it is claimed today.

Coronary heart disease occurs when artery walls become thickened with fatty deposits, preventing blood from adequately reaching the heart.

Revascularisation can improve blood flow and reduces the risk of death. The procedure can be carried out either by non-invasive stenting or bypass surgery.

Studies published in today’s edition of the British Medical Journal (BMJ) question the cost and clinical effectiveness of stenting.

Two of the studies argue that in the medium to long term, surgery is at least as effective and probably more cost effective, than stenting. The third report claims the benefit of stenting over medical or surgical treatment is “too small to justify its additional costs”.

Writing in the BMJ, David Taggart, professor of cardiovascular surgery at the University of Oxford, said that despite these findings, people still prefer the non-invasive aspect of stenting.

This could deny patients with multi-vessel disease being denied the chance to survive longer as surgery has been proved to be more effective for this particular condition.

“This highlights the dangers of individual practitioners rather than multidisciplinary teams making recommendations for stenting in patients with multi-vessel disease,” he writes.

“Such teams should include a non-interventional cardiologist and surgeon and are likely to offer more balanced advice.”

Responding to the research, Professor Peter Weissberg, medical director at the British Heart Foundation, sought to reassure heart disease patients of the quality and range of treatment available to them.

“Thanks to decades of research and development of skills in this area, heart patients now have access to two very successful treatments: surgery or stents. Both are effective treatments to restore blood flow in the heart,” he said.

“People should be reassured that doctors will make sure they get the best possible treatment available to them.”