Clot-buster drugs, angioplasty aid recovery -- study
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Updated: 2001-08-07 11:03

Scientists found patients who had restored blood flow in their arteries before surgery were more likely to emerge from the procedure with normal blood flow, and were less likely to die in the hospital or suffer long-term complications such as heart failure.

"This study supports the concept of a large randomized trial to evaluate whether powerful clot-busters are beneficial before routine angioplasty," Dr. Gregg Stone, of the Lenox Hill Heart and Vascular Institute in New York and the Cardiovascular Research Foundation, told Reuters.

Angioplasty is a surgical technique to treat blocked coronary arteries.

Heart attacks occur when blockage to an artery in the heart reduces or completely cuts off blood flow, causing a clot to form. The American Heart Association estimated 1.1 million Americans will have a new or recurrent heart attack this year.

Stone and his colleagues studied data from 2,500 people who had participated in four earlier studies in which patients underwent an angioplasty without receiving clot-busting drugs. They found that following an angioplasty, patients whose blood flow had returned naturally to normal levels prior to the surgery suffered the lowest mortality rate.

The data showed that six months after an angioplasty, 0.5 percent of patients whose blood flow returned to normal levels had died compared with 4.4 percent of those who showed no improvement at all. This led researchers to believe that clot-busting drugs could achieve higher levels of blood flow before surgery than occur naturally in the body.

Stone said further trials to study the combination therapy will begin within eight months, and will focus on using stronger clot-busting drugs to open 50 percent to 60 percent of arteries before angioplasty. Researchers said 20 percent of arteries naturally returned to normal levels in the preliminary phase.

But Stone cautioned that "while (opening coronary arteries further) seems inherently obvious, we have to remember these clot-buster drugs have serious side effects such as bleeding, and they are expensive," Stone said.

More than 539,000 angioplasty procedures were performed in 1998, the year for which the most recent figures are available, the American Heart Association said. That's up 248 percent from 1987.

The study appeared in the journal Circulation, published by the American Heart Association.

Earlier studies during the 1980s had shown that the two treatments used together were of little benefit and actually could be harmful to patients. But Stone said advances in clot-busting drugs and better angioplasty technology warrant further investigation into the combined therapy.

"We are at the point where we should be looking at (combination studies), where in the early '80s it was really premature," Stone said. "Heart disease is still the number one cause of death, and ... we still have a long way to go."

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