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Heart study jolts drugs-versus-stents debate

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KAI RYSSDAL: If you’ve got a weak heart, New Orleans is the place to be this week. Not for any of that Big Easy stuff. But because there’s a cardiologists’ convention in town. As usual, they’re issuing a raft of reports about how to treat the country’s biggest killer. One of those studies got so much buzz today it started to move the markets. So it was released early.

There’s some evidence heart stents — tiny metal scaffolds doctors put into arteries to hold them open — don’t work as well as drugs.

Helen Palmer reports from the Marketplace Health Desk at WGBH.

HELEN PALMER: This new trial is the first to study whether stents reduce heart attacks and death: 2,300 patients with stable heart disease — that’s chest pain, but no imminent risk of a heart attack — were split in two. One group got aggressive drug treatment, the other drug treatment plus stents. Koon Teo was one of the investigators. He spoke on his cell phone from the conference.

KOON TEO: There was no difference in terms of heart attacks and deaths in the two groups.

Teo teaches medicine at McMaster University. He says the study suggests lifestyle changes and drug therapy should be the first plan for stable heart patients.

But stents can also cause blood clots, and Wall Street analysts reckon now cardiologists will become increasingly cautious.

THOM GUNDERSON: This study will add to the concern about using stents in general.

Piper Jaffrey’s Thom Gunderson says media attention helped fuel today’s drop in the stock price of some makers of stents, like Boston Scientific and Medtronic. But Gunderson say this study’s flawed. It looks at heart attacks and death, and that’s not what stents are for.

GUNDERSON: Was there a reduction in heart pain? Was there an increase in the quality of life? That’s what stents are made to do is reduce the chest pain and give you the opportunity to play a full 18 without having to quit early.

Stent makers also criticize the trial. It used older devices, not the new ones coated with drugs to keep arteries open better. And they warn if cardiologists get skittish about using the devices, more people may end up with acute heart disease.

In Boston, I’m Helen Palmer for Marketplace.

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