Study: Drugs cheaper, as effective as stents, for treating heart attack

The (Raleigh) News & ObserverFebruary 19, 2009 

It's much cheaper and just as effective to treat some heart attacks with drugs instead of also trying to snake a stent into a clogged artery, scientists at Duke University report Thursday in the New England Journal of Medicine.

The findings could prompt significant savings for many of the estimated 1.2 million Americans who suffer heart attacks each year. Wire mesh stents open clogged arteries and can save lives when used within a few hours of a heart attack, but they're no more beneficial than clot-busting drugs alone if the attack occurred a day or so before the patient sought treatment.

Forgoing stents in those cases could save an average of $7,000 per patient – or $700 million for the estimated 100,000 U.S. heart attack patients who don't need them.

Those kinds of savings are key components of President Barack Obama's stimulus plan. Included in the legislation is more than $1 billion to enhance the science behind medical practices, which often favor technology and high-priced interventions over less-expensive approaches such as drugs, even though the health benefits are unknown or dubious.

Though breakthroughs in new drugs, devices and surgeries have contributed to a longer life expectancy in the United States, they haven't come cheaply. Spending on health care in the United States tops $2 trillion a year and has risen nearly 10 percent annually since 1970.

"We need to put more resources into research to know what works and doesn't work for same medical conditions," said Joel Miller, senior vice president for operations at the National Coalition on Health Care, a Washington health advocacy group. "Physicians and patients need better data, and this is a case in point."

Stenting is a potentially life-saving procedure when a patient arrives in the emergency department in the throes of a heart attack. Routed with a catheter up a large blood vessel in the groin, the wire scaffold is expanded in the blocked artery by a small balloon, restoring blood flow and keeping vital heart tissue from dying.

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