Study bats for restricting patients’ stents

Mumbai: A state government study of heart patients who underwent angioplasty from 2012 to 2016 has shown that survival outcomes in heart patients can be improved by restricting stents implanted only to blockages known to cause heart disease.

Commissioned by the state’s public health department, over 4,595 stable heart disease patients from over 110 hospitals across all districts of Maharashtra were studied over four years,  from 2012 to 2016. The study revealed that using too many stents could be counter-productive and could even increase chances of death.

 The study published in ‘PLOS One’ on May 24, 2018, was initiated in 2012 by the then secretary of the state public health department, Meeta Rajivlochan, over concerns about high mortality rates in angioplasty procedures carried out under the state government’s health insurance scheme, Mahatma Jyotiba Phule Jan Arogya Yojana.

 Dr Bhanu Duggal, department of cardiology, AIIMS, Rishikesh, said, “Our study shows an all-cause mortality of 4.5 per cent (203 deaths) in patients in the one-year period after the procedure, which, in western countries, is 1.7 per cent. The study also compared patient outcomes for bare metal stents (BMSs) and drug-eluting stents (DESs). It found that while survival rates in both types were similar, there was a slightly reduced chance of re-hospitalisation and repeat procedures when DESs were used,”

 The report stresses that involving a team of doctors including a primary cardiologist, interventional cardiologist, and cardiac surgeon in the assessment of the patient should be standard practice.