Emergency heart patients do better with angioplasty compared to medication

Reported by Susan Aldridge, PhD, medical journalist

Early angioplasty for heart attack patients is linked to better survival in both short and long term, according to a new analysis.
When someone is admitted to hospital with worsening chest pain the problem may be unstable angina or a heart attack. Treatment can be either invasive - with cardiac catheterization used to identify any blockages followed by angioplasty or bypass - or by medication. In the latter situation, high risk patients would be identified and then offered more invasive treatment. There's been some debate over which approach is best. Now doctors at the University of Queensland, Australia, reveal an analysis of five major trials which compare the invasive over the conventional approach to chest pain, unstable angina and heart attack.

In both the short and long term, angioplasty or bypass offered a survival advantage over medication alone. The analysis found that those given angioplasty were one third less likely to suffer uncontrolled chest pain or to be hospitalized six to 12 months after initial admission. In the longest follow up, those offered immediate invasive treatment had a 25 per cent lower risk of death or of having a second heart attack two to five years after the initial event. However, invasive approaches such as angioplasty are not without their own risks - patients may have a procedure-related heart attack or may experience some bleeding side effects during the initial hospitalization. In view of this, it may not be a good idea to automatically give all chest pain patients angioplasty. A careful risk benefits consideration should be done first for all patients who are admitted for a heart attack.

Source
The Cochrane Library 2006 Volume 3