The NY Times has an article about how stents are likely to be found to be less useful than would be indicated by the amount of use they get from cardiologists. More bad news for JNJ and BSX, but something that THCB has been sniffing around for quite some time now.
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I find this whole issue fascinating.
The idea that stenting someone with anginal symptoms and significant narrowing on coronary angiography possibly being worthless for mortality is, quite simply, shocking.
It’s only so they can walk up the stairs more comfortably?
Let’s say the study shows that in stable angina patients, stenting gives no mortality benefit. My next question is what do we do with the patients who are having their “first stable angina symptoms?” (which, by definition, is unstable angina). Optimize their risk factors and wait for their infarction before intervening?
The malpractice implications of this are huge too. Maybe the concept of “missing an impending heart attack” will eventually fade if we shouldn’t be stenting narrowings in the absence of active infarction.
Someone who knows more about this than I do, please comment.