Results of Study on Stenting Chest Pain Patients Misinterpreted: Researchers

By Ubelacker, Sheryl | The Canadian Press, November 9, 2017 | Go to article overview

Results of Study on Stenting Chest Pain Patients Misinterpreted: Researchers


Ubelacker, Sheryl, The Canadian Press


Stent or not to stent: study ignites debate

--

TORONTO - It's hard to believe that a single small study could cause such a hullabaloo, but that's been the case with a research paper that looked at the effectiveness of using stents to open up clogged coronary arteries in patients with chest pain known as angina.

The U.K.-led study published last week in The Lancet has sparked a heated international debate among doctors about how best to treat such patients -- by inserting a mesh tube into their blocked artery to improve blood flow or by prescribing anti-angina pills?

"I think there was a lot of hysteria here," said study co-author Dr. Justin Davies, a professor of cardiology at Imperial College London, pointing to the headline on a New York Times story about the study: "'Unbelievable': Heart stents fail to ease chest pain."

Dr. Rasha Al-Lamee, an Imperial College interventional cardiologist who led the study, was somewhat more circumspect in her reaction to how the findings were interpreted by some heart disease experts quoted by various media outlets.

"I think that perhaps some of their statements were an overreach of the results," she said from London. "In America, it has been quite incredible."

The 2014-17 ORBITA study enrolled 230 patients with one blocked coronary artery -- there are three such major vessels -- who were experiencing chest pain and reduced exercise capacity on speed-modified treadmill stress tests.

Patients were treated over six weeks with increasing doses of anti-angina medications, such as heart rate-reducing beta blockers and blood thinners, then randomized half and half to undergo either insertion of a stent or a sham procedure that left their blocked artery as it was. In what's called blinding to prevent biased results, patients were not told which procedure they received.

Despite which group the patients were in -- stent or no stent -- both reported some improvement. But researchers said the difference between the two groups was not statistically significant.

"We found, to our surprise, that while the stents improved the blood supply to the heart in this population of people with disease in just one artery ... we didn't significantly improve how they felt in terms of symptoms or how they did in terms of walking on an exercise path, more than a placebo (sham) procedure," said Al-Lamee.

"It probably means that stable angina is quite complex and fixing narrowing you see with stents doesn't probably fix everything, because these people may have disease in the small arteries we don't see (with imaging)," she said.

"They might have chest pain for other reasons, they may be limited because of other factors that are not their heart."

However, some heart specialists interpreted the findings to mean that the long-used practice of stenting -- known medically as percutaneous coronary intervention, or PCI -- to treat angina should be re-assessed.

Among them were Dr. David L. Brown of the Washington University School of Medicine and Dr. Rita F. Redberg of the University of California-San Francisco, who prepared an editorial review of the study for The Lancet. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Results of Study on Stenting Chest Pain Patients Misinterpreted: Researchers
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.