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By Vivian Richardson, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire) -- Often, a decrease in blood flow to the heart, called ischemia, results in chest pain. When the chest pains aren't there, treatment is still needed to reduce the patient's risk of heart attack. New research reveals patients treated with angioplasty for silent ischemia fare better than patients treated with drug therapy alone.
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Cardiac ischemia occurs when the heart muscle does not get enough blood. Silent ischemia is so-called because patients have no outward symptoms of the condition. An electrocardiogram, however, can detect the reduced blood flow. Previous studies have shown patients with silent ischemia following a heart attack have an increased long-term risk of further heart problems.
Researchers in Switzerland studied 201 patients who suffered a heart attack and were diagnosed with silent ischemia. Approximately half of the patients underwent percutaneous coronary intervention, or angioplasty, and half of the patients received intensive anti-ischemic medication. The researchers followed the progress of the study participants for 10 years.
Twenty-seven adverse cardiac events were reported in the group of patients who underwent angioplasty, where a physician opens blocked blood vessels in the heart using a balloon catheter. In the group that received drug therapy for ischemia, 67 adverse cardiac events occurred.
Richard Becker, M.D., director of the Director Cardiovascular Thrombosis Center at Duke University School of Medicine, told Ivanhoe this study emphasizes the need for continuing care for patients who've suffered a heart attack. "It certainly emphasizes the importance of identifying impaired blood and oxygen supply to the heart muscle after a person has had a heart attack," Dr. Becker said. He was not involved with the study.
The study has a few weaknesses, explained Dr. Becker, including the fact that many of the patients in the drug therapy group were taking the medications that were available 10 years ago. "If this study were to be done in 2007 with medications that are available today ... I think that we would see the groups come a little closer together. But I also think we would find that there are some individuals that would benefit from a combination of intense medical therapies as well as angioplasty," he said.
"We often find that even with the best that we have to offer, the best medicines and angioplasty, that there would be an opportunity to improve care even further with new drugs and new platforms of research that are ongoing now," said Dr. Becker.
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
SOURCE: Interview with Richard Becker, M.D., The Journal of the American Medical Association, 2007;297:1985-1991
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