New research offers reassurance over multiple artery procedures for heart attack victims
Issued by University of Leicester Press Office on 17 December 2015
'The results of this study provide reassurance that specialists treating patients with a heart attack can open more than one narrowed artery without increasing the total amount of heart damage.’
- Dr Gerry McCann, NIHR Career Development Fellow, University of Leicester & Leicester’s Hospitals
A new study has examined the effects on the heart of treating multiple narrowed arteries - rather than just one – at the time of a heart attack.
Specialist heart doctors increasingly treat patients with large heart attacks urgently with a procedure under local anaesthetic. The blocked blood vessel (artery), which causes the heart attack is opened by inserting a small metal scaffold (stent) at the blockage to hold the artery open.
Now a study led by Dr Gerry McCann, NIHR Career Development Fellow from the University of Leicester and Leicester’s Hospitals, has examined whether treating more than one artery has an adverse effect on the heart.
Dr McCann said: “Up to 50% of patients treated for a blocked artery also have other narrowed, but not totally blocked, heart arteries. Two recent studies in patients with heart attacks and multiple narrowed arteries have suggested that treating all of the narrowed arteries may be better than just treating the blocked artery.
“However, there is concern that the longer procedure, and putting in more stents, may cause more damage to the heart.”
The researchers studied 203 patients having a heart attack who were randomly assigned to have only the blocked artery (105 patients) or all the narrowings treated (98 patients) in seven hospitals in England.
Dr McCann said: “We assessed the amount of heart muscle damage that occurred with MRI scans. Patients who had all the heart arteries treated had more than one area of heart muscle damage more frequently (22% v 11%) than those who just had the blocked artery treated. However, the percentage of the heart that was damaged was not increased (12.6% v 13.5%) and the heart function early and nine months afterwards was similar with both treatments.
“The results of this study provide reassurance that specialists treating patients with a heart attack can open more than one narrowed artery without increasing the total amount of heart damage.”
Professor Peter Weissberg, Medical Director at the British Heart Foundation, which helped fund the study, said: “In the process of identifying and opening, by using a stent, the blocked artery causing a heart attack, the cardiologist may discover other narrowed arteries. There has been much debate as to whether the cardiologist should stent these additional narrowings at the same time.
“This study suggests that it is safe for the cardiologist to insert a stent into all narrowings they discover while treating a heart attack. However, cardiologists must make a judgement at the time as to whether an artery is narrowed enough to warrant insertion of a stent.
“From the patient’s perspective it is essential that he or she calls 999 at the first signs of a heart attack – most commonly discomfort in the chest so that they can be swiftly assessed and treated. The blocked artery causing a heart attack must be cleared as soon as possible.”
Dr McCann is Reader at the University of Leicester and Honorary Consultant Cardiologist at Glenfield Hospital. This research is published in JACC, the Journal of the American College of Cardiology. The work was funded by the Efficacy and Mechanism Evaluation Programme, an MRC and NIHR partnership. It is a sub study of the CvLPRIt trial that was also led by Leicester Professor Tony Gershlick and funded by the British Heart Foundation.
NOTES TO EDITORS:
For interviews contact: Dr Gerry McCann via University of Leicester press office: firstname.lastname@example.org
About the funders:
1. The project is managed by the Efficacy and Mechanism Evaluation Programme, an MRC and NIHR partnership, that supports later-phase “science-driven” clinical trials and evaluative studies, which seek to determine whether a health intervention (e.g. a drug, diagnostic technique or device) works and in some cases how or why it works. The programme is funded by the MRC and NIHR, with contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland. www.nets.nihr.ac.uk/programmes/eme
2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk)
The project was supported by the NIHR Leicester Cardiovascular Biomedical Research Unit
3. The Medical Research Council has been at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Twenty-nine MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms. www.mrc.ac.uk
4. About the British Heart Foundation
Coronary heart disease is the UK’s single biggest killer. For over 50 years we’ve pioneered research that’s transformed the lives of people living with heart and circulatory conditions. Our work has been central to the discoveries of vital treatments that are changing the fight against heart disease. But so many people still need our help. From babies born with life-threatening heart problems to the many Mums, Dads and Grandparents who survive a heart attack and endure the daily battles of heart failure. Join our fight for every heartbeat in the UK. Every pound raised, minute of your time and donation to our shops will help make a difference to people’s lives.
For more information visit bhf.org.uk