Routine invasive procedures for stable heart disease found to offer no long-term survival advantage over drug therapy
Patients with stable heart disease and abnormal stress tests who have invasive procedures early in their care do not live longer than those initially treated with drugs and lifestyle changes alone, an international study shows.
An international study involving over 5,000 patients with stable coronary artery disease has found that early invasive procedures, such as stent implants or bypass surgery, combined with medications and lifestyle changes do not provide a long-term survival advantage compared to initial medical therapy alone. The study, ISCHEMIA-EXTEND, which followed patients for nearly a decade, found that death rates were essentially the same between the two approaches - 26% for the invasive approach and 27% for the conservative approach.
Co-lead author Judith S. Hochman, a cardiologist, explained that while early heart procedures help relieve chest pain and improve quality of life, they are unlikely to lead to longer survival. The findings challenge the long-held belief that early intervention prevents life-threatening problems later in patients with stable heart disease.
The study, presented at the American Heart Association's annual Scientific Sessions and published in the Journal of the American Medical Association, emphasizes the need for careful discussions between patients and healthcare providers about the goals and trade-offs of different treatment options.
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