There are demonstrably no benefits to the hundreds of thousands of angioplasty and stent procedures performed outside of an emergency setting. They don’t prevent heart attacks, enable you to live longer, or even help with symptoms any more than placebo (sham) surgery.
Large national cardiology conferences may attract the majority of cardiologists across an entire country, convening them in one place. “While at the large cardiology conventions…[it’s been] joked that the convention center would be the safest place in the world to have a heart attack.” And, indeed, that’s when the American Heart Association president had his, within hours of his presidential address. With so many of the nation’s top cardiologists at a conference, that may be a bad time to go into cardiac arrest anywhere else, though. You don’t know until you put it to the test.
To much surprise, researchers found substantially lower mortality among those going into cardiac failure or cardiac arrest during the dates of national cardiology meetings. Why is the death rate lower when most of the cardiologists are away? “‘One explanation for these findings is that the intensity of care provided during meeting dates is lower and that…the harms of this care may unexpectedly outweigh the benefits,’ the researchers wrote.” Their results “echo paradoxical findings documented during a labor strike by Israeli physicians in 2000, in which hundreds of thousands of outpatient visits and elective surgical procedures were canceled, but by many accounts mortality rates dramatically fell during the year.” And it wasn’t just one strike. “Doctors’ strikes and mortality” have been looked at multiple times. In all reported cases, “mortality either stayed the same or decreased during, and in some cases, after the strike.” In four of the seven cases, “mortality dropped as a result of the strike, and three observed no significant change in mortality during the strike or in the period following the strike.”
The fact is that many current medical practices have been found to offer no benefit and present potential harm. Even physicians themselves estimate that about one-fifth of medical care is unnecessary. A national summit was convened by The Joint Commission, which accredits hospitals, and the American Medical Association to identify areas of overuse, “described as the provision of treatments that provide zero or negligible benefit to patients, potentially exposing them to the risk of harm.” Five practices were called out, including prescribing antibiotics for viral upper respiratory tract infections and spending a billion dollars prescribing drugs that don’t work (and, if anything, make things worse). Another overused practice identified was elective percutaneous coronary intervention (PCI)—in other words, angioplasty and stents, as I discuss in my video Do Angioplasty Heart Stent Procedures Work?.
To get everyone on the same page before we dive in: Coronary artery disease, the number one killer of men and women, involves blockages in the blood vessels that supply the heart muscle itself. Low blood flow can lead to angina, a type of chest pain, or, if it’s severe enough, to a heart attack. Plant-based diets and lifestyle programs have been shown to reverse these blockages by treating the cause of why our arteries are clogging up in the first place, but for those unable or unwilling to change their diets, there are drugs that can help, as well as more invasive treatments, such as open-heart surgery to try to bypass the blockage or percutaneous coronary intervention, when “doctors insert small balloons or tunnels (stents) attached to flexible tubes (catheters) into the large blood vessels in the patient’s groin and thread them up into the heart. The stent and catheter are passed through the blocked vessels, a process that opens up the vessels.” In this way, they can get inside the blocked vessels and try to open them up and keep them propped open. During a heart attack, this can be lifesaving, but hundreds of thousands of these procedures are performed every year for stable angina, meaning on a non-emergency basis. It can relieve angina symptoms “but it does not reduce a person’s chances of having or dying of a heart attack.”
However, not everyone knows that. “Some patients and doctors mistakenly believe that PCI does more than just reduce symptoms.” That’s one of the reasons I’ve created a video series on the topic. As Harvard put it: “Stents are for pain, not protection.” Then, unbelievably, it was discovered that stents may not even help with pain, as revealed in a double-blind, randomized controlled trial. People can be blinded to the active treatment in a drug trial by receiving a placebo sugar pill, but wouldn’t they notice if they had surgery? If a doctor cut into their groin? Not if they had sham surgery—placebo surgery. “In both groups, doctors threaded a catheter through the groin or wrist of the patient…up to the blocked artery. Once the catheter reached the blockage, the doctor inserted a stent or, if the patient was getting the sham procedure, simply pulled the catheter out.” The results? Those who underwent the fake surgery did just as well as those who had the regular PCI surgery.
There are no benefits to angioplasty and stents outside of an emergency setting. They don’t prevent heart attacks, they don’t enable us to live longer, and they don’t even help with symptoms. “Since the procedure carries some risks, including death, stents should be used only for people who are having heart attacks…” How are hundreds of thousands of people getting these operations for nothing? How do the doctors justify it? Is it just greed? How do they get patients to consent to it? Do they just not tell them the truth? And why doesn’t it work? After all, a blocked artery is being opened up. There are just so many questions, which we’ll start addressing next.
