CHICAGO — Landmark research that should have changed the way doctors treat millions of heart patients with clogged arteries has had little effect — many still don’t first try medicines that sometimes eliminate the need for costly, invasive procedures, a study suggests.
The 2007 research — front-page news when it was published — showed that intensive drug treatment in nonemergency patients with chest pain worked as well as angioplasty in preventing heart attacks, improving survival and relieving discomfort in the long run.
To measure the research’s impact, the new study evaluated data on nearly half a million U.S. patients with artery blockages but stable disease treated from 2005 to mid-2009. Two-thirds had chest pain, and all eventually got artery-opening stents during an angioplasty.
Before the landmark findings, fewer than half the patients received drug treatment first, then an angioplasty. In the two years after the study, there was only a tiny increase in patients given drug treatment first — to about 45 percent.
The earlier research suggests many of those given drugs first wouldn’t need an eventual angioplasty, said Dr. William Borden, author of the new study and a cardiologist at New York-Presbyterian Hospital/Weill Cornell Medical Center.
He said the 2007 results also show all patients should get drug treatment after an angioplasty to help prevent heart attacks. In his follow-up study, that number increased slightly, but still, almost one-third were not given recommended medication after their angioplasties.
Dr. William Boden of Buffalo General Hospital, who led the 2007 study, said the new results aren’t surprising because it takes time for doctors to change practice. The landmark study’s recommendations will be included in new treatment guidelines due out this year, said American Heart Association spokesman Dr. Sidney Smith. He said that should influence more doctors to use the drug approach first.
