Challenge traditional cognition! Many patients with heart disease may not need stent and bypass surgery urgently

Recently, the results of a clinical trial released at the annual meeting of the American Heart Association (AHA) challenged people's awareness of the prevention of heart disease and cardiovascular death! The $100 million clinical trial, funded by the U.S government, showed that many patients with cardiovascular disease who received stent or bypass surgery had no significant advantage in reducing heart attack and death compared with the best drug treatment This means that for patients with stable heart disease, invasive surgery to improve blood flow is not necessarily a "priority." Cardiovascular disease is one of the leading causes of death in the world Among them, many patients due to vascular obstruction, resulting in heart blood shortage, which will cause chest pain Treatments include aspirin, drugs to lower cholesterol and blood pressure, and changes in diet and exercise habits However, many doctors will also recommend surgery to improve the blood supply to the heart, which is usually a bypass or angioplasty Bypass surgery involves opening the patient's chest, reconnecting the patient's blood vessels and bypassing the blocked area Angioplasty is a kind of minimally invasive surgery, through balloon or stent to restore the narrow blood vessels, so that the blood flow is unblocked again However, the effectiveness of these invasive procedures in preventing heart attack and cardiovascular death in non emergency patients has been controversial As a result, the U.S federal government spent $100 million to support a clinical trial of 5179 patients in 37 countries To test the effectiveness of invasive surgery in preventing heart attack and cardiovascular death in patients with stable heart disease compared with the best drug treatment The results showed that when the median follow-up time was 3.3 years, there was no significant difference in the incidence of major cardiovascular events (13.3% vs 15.5%, P = 0.34) between patients who received invasive surgery immediately and those who delayed the surgery Invasive surgery increased the incidence of these major adverse cardiovascular events by ~ 2% in the first six months after surgery, and reduced the incidence of adverse events by ~ 2% in the fourth year after surgery For patients who often have chest pain, invasive surgery significantly reduces the frequency of chest pain and improves their quality of life For patients without chest pain, there was no significant improvement in the quality of life For patients with acute heart attacks, invasive surgery is a powerful tool to save their lives, industry experts say However, this study shows that patients with stable conditions, especially heart disease without chest pain symptoms, do not need to receive invasive surgery immediately, and there will be no adverse consequences if they try drug treatment reference material: [1] Big study casts doubt on need for many heart procedures Retrieved November 17, 2019, from https:// [2] Stents and bypass surgery are no more effective than drugs for stable heart disease, highly anticipated trial results show Retrieved November 17, 2019, from https:// [3] International Study of Comparative Health Effectiveness With Medical and Invasive Approaches – ISCHEMIA Retriebed November 17, 2019, from https:// A kind of