Heart attacks need to be treated differently: the traditional approach is becoming obsolete

UNITED STATES, WASHINGTON (OBSERVATORY) — It has been reliably established that about half of the victims of a heart attack have additional blocked arteries, in addition to the one that caused the heart attack.

Nevertheless, doctors around the world traditionally perform stenting of only one artery, leaving the treatment of the others to the disposal of drug therapy.

A new study involving 130 hospitals in more than 30 countries showed that eliminating all blockages is much more effective . This reduces the risk of a patient dying or having a heart attack by 26%.

This study, known as COMPLETE, was published in The New England Journal of Medicine and presented at the Congress of the European Society of Cardiology and the World Congress of Cardiology in Paris.

“Given the large sample size, international coverage and focus on long-term patient health, we believe that COMPLETE will change the approach to treating heart attacks all over the world,” said study leader Dr. Shamir R. Mehta, professor of medicine at the Health Research Institute at PHRI ) McMaster University.

The PHRI COMPLETE study, funded by the Canadian Institute for Health Research, involved 4,041 patients, and this is the first large randomized international study to show a reduction in mortality and recurrent heart attacks while restoring patency of all arteries.

“The benefits were similar when additional stenting procedures were performed during the first 45 days after a heart attack, ” Dr. Mehta said, “This study clearly showed that serious cardiovascular complications can be prevented in the long run by restoring patency of all clogged arteries.” In addition, there were no serious flaws in the installation of additional stents.

On average, over the course of three years, indicators of a second heart attack or cardiovascular death decreased to 7.8% in patients with complete revascularization, compared with 10.5% of those who were given a stent only for a heart attack-related artery.

The advantage was even greater when considering other adverse events, such as severe chest pain requiring a repeated stenting procedure. There were no differences between groups regarding other side effects, including stroke and massive bleeding.


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