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Stents Not as Useful as we Think, Shows Lancet Study

The Study says that stents -- tiny wire mesh medical devices used to open blockages in blood vessels -- do nothing to relieve angina pain.

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Updated:November 6, 2017, 1:02 PM IST
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Stents Not as Useful as we Think, Shows Lancet Study
In this file photo, a heart surgeon holds a stent, which is inserted into constricted coronary arteries to help keep them open and normalise blood flow, as he performs a surgery on a patient with a blood clot in the carotid artery. (Photo: Reuters)
New Delhi: Building on years of evidence, a new study in The Lancet showed that stents were useless for most suffering angina pain. Conducted by researchers in the United Kingdom, the study shows that stents -- tiny wire mesh medical devices used to open blockages in blood vessels -- do nothing to relieve angina pain. They improve blood supply when inserted in a vessel, but do not act on the symptoms.

Angina is a chest pain caused by reduced flow of blood to the heart. The results here are for for those suffering stable angina, or angina pectoris, which acts up due to physical exertion or emotional distress. They do not apply to patients with unstable angina, which happens suddenly and can worsen into a heart attack.

Since heart disease is the India’s biggest killer, stents are used liberally here. In 2017, 1.7 million Indians died from heart disease, according to this year’s Global Burden of Disease report.

Over years, the necessity and efficacy of stents in relieving chest pain has been questioned, but The Lancet study, published November 2, gave proof through a rare process in clinical trials. The researchers conducted sham surgeries on half of their subjects, only pretending to insert stents.

Of the 230 participants with stable angina, 195 were randomly assigned procedures. Of those, 105 were given stents -- percutaneous coronary intervention (PCI) -- and 95, the control group, were given placebo procedures, where a catheter was inserted and then removed without placing a stent. The study had a double blind, which meant neither the participants nor the doctors who subsequently followed them for six weeks knew who had what procedure.

At the end of the study, the researchers said, “there is no evidence from blinded, placebo-controlled randomised trials to show its [PCI] efficacy”.
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