If you’ve had a heart attack or recurring angina, chances are you’ve either had or been recommended to have an angioplasty. Or, as it’s now called, percutaneous coronary intervention.
Contrary to popular belief, however, angioplasty does not prevent heart attacks or save lives.
Studies show harm
Conventional wisdom dictates that angioplasty is best done within 12 hours after a heart attack, but at least a third of patients aren’t treated within that time frame. Nevertheless, “late” angioplasty is routinely performed on the assumption it provides benefit. Well, it doesn’t.
A large, multicenter study published in the New England Journal of Medicine revealed when angioplasty was done three to 28 days after a heart attack, it failed to reduce occurrence of death, repeat heart attacks or heart failure.
Even worse, during four years of follow-up, there were more heart attacks in the group that had angioplasty, compared to those treated conservatively with drugs.
“Cures” worse than the disease
It’s very difficult for me to read studies like this. It’s like additional evidence that the Earth is round. Angioplasty, bypass and other invasive heart procedures do not and cannot prevent heart attacks or prolong lives in the vast majority of patients who have them.
Way back in 1983 – long before angioplasty became the revenue-generating darling of cardiology – the Coronary Artery Surgery Study was published. This definitive clinical trial was expected to confirm the benefits of bypass surgery in patients with significant heart disease.
Instead, the study showed bypass was a bust. Rates of heart attack and death from heart disease were no lower in patients who had surgery than they were in a similar group treated without surgery.
The death rate in the patients who didn’t have bypass was a surprisingly low 1.6 percent per year. The chance that any surgery will improve upon a death rate this low is virtually nil.
It boils down to one indisputable fact: You cannot save the life of someone who is not going to die.
The findings from this study are as relevant today as they were 27 years ago. At the time of the study trials, the death rate of patients 65 and older hospitalized for bypass was 11 percent.
While the in-hospital death rate for bypass has dropped to 2.2 percent (this includes all age groups; it’s higher for older people), the annual mortality rate for patients with heart disease treated with noninvasive methods has fallen below 1 percent – meaning you’re still more than twice as likely to die from the surgery as from the disease.
I’ve said for more than 20 years that a middle-school math student could take these figures and determine that the current use of invasive heart procedures is fraud.
When you weigh the certain pain and cost of surgery against the slim chance of benefit, it’s an easy call.
Yet today, bypass, angioplasty, and other “lifesaving” heart procedures continue to be foisted upon more and more folks who don’t need them.
Follow the money
If hard science and patient benefit were central factors at work here, these procedures would be a rarity. But invasive cardiology has nothing to do with science. It has nothing to do with saving lives or improving quality of life. It has to do with money. Period!
According to the American Heart Association, every year in U.S. hospitals, more than 1,300,000 angioplasties are performed at about $38,000 each and nearly 500,000 bypass surgeries at nearly $84,000 per operation. These and other heart procedures generate more than $121 billion a year, a windfall that makes up approximately 45 percent of the total revenue of most hospitals!
That’s why angioplasty and bypass remain popular, despite dozens of studies that have been conducted over the past quarter-century – not one of them showing that either procedure prevents heart attacks or premature death for the overwhelming majority of people.
Scared into surgery
The millions of patients required to fill beds in cardiac-care centers across the country aren’t hard to come by. All a heart surgeon or interventional cardiologist has to do is tell them, “If we don’t operate, you’re going to have a heart attack in the parking lot.” Presto!
Grossly misinformed and frightened, people quickly embrace these “lifesaving” therapies.
One such patient is Lee. In 1997, he had a heart attack and underwent angioplasty. Within months, his angina returned, and he was told the artery had closed up. So he had another angioplasty, then another. Lee finally ended up having a bypass.
Despite all this, Lee couldn’t walk more than half a block before severe chest pain and pressure forced him to stop and rest.
You do have options
When Lee came to my clinic, we treated him as we treat all of our patients with heart disease.
We started him on a therapeutic diet and a mild exercise program. He underwent noninvasive treatments such as enhanced external counterpulsation and hyperbaric oxygen therapy to restore blood flow and help build collateral circulation.
He began taking multiple supplements to address the underlying causes of heart disease, including fish oil to counter inflammation, policosanol to lower his cholesterol, nattokinase to improve blood flow and coenzyme Q10 to strengthen his heart.
Today, Lee rides his bicycle five to 15 miles a day and walks on a treadmill for 30 minutes at a 9-percent incline without chest pain or pressure. He has lost 25 pounds and states that he feels better than he has in 10 years.
Look before you leap
We see patients with improvements as dramatic as Lee’s every day. It’s not that hard to help them – we simply go back to the basics.
Heart disease is systemic, not localized to a specific artery. The condition is multifactorial, not just about cholesterol and blood pressure, and it is best treated by addressing all of the factors that increase heart-attack risk.
The most disheartening aspect of the bypass-angioplasty charade is it prevents people from receiving appropriate care. Going after blockages with bypass is not the answer. It just gets in the way, frequently making the situation worse.
In reality, if we tied the thumbs of all catheter-pushing cardiologists and heart surgeons, the death rate from cardiovascular disease would decline dramatically.
My advice: You need to think this invasive-cardiology issue through now, not when you’re lying in the ER with a doctor telling you you’re going to die if you don’t do something right away.