After a heart attack, unclogging all the arteries as a preventive measure instead of only dealing with the one responsible for the infarction would reduce the risk of death, researchers reveal.
A heart attack is damage to the heart muscle. In the vast majority of cases, it is linked to a blood clot that blocks a coronary artery. When blood flow is slowed or blocked, heart muscle tissue does not receive enough oxygen. It necroses, which has very important repercussions on the functioning of the heart. But while about half of patients who have a heart attack have more than one clogged artery, doctors still focus on opening up the culprit, leaving the rest to the drugs to take care of.
According to a new study published on Sunday 1 September in the New England Journal of Medicineafter a heart attack, clearing all the arteries with a stent reduces the risk of having another myocardial infarction and dying from it by 26%. These results were also presented at the Congress of the European Society of Cardiology which is held until September 4 Porte de Versailles in Paris.
Drop in risk of second heart attack or death
The researchers analyzed data from 4,041 patients from 130 hospitals in 31 different countries. They were thus able to observe that, over a median period of three years, the risk of a second heart attack or death fell to 7.8% in those who had undergone complete revascularization against 10.5% in the others. The benefit was even greater when taking into account other adverse events like severe chest pain requiring repositioning, for example.
Finally, no difference was observed in terms of side effects, note the researchers who recall that this is the first study of its kind. “Given its large size, international reach and emphasis on patient-centric outcomes, the COMPLETE trial (the name of the study) will change the way doctors treat this disease and prevent thousands of recurring heart attacks every year worldwide,” says Dr Shamir R. Mehta of the Population Health Research Institute (PHRI) at McMaster University (Canada), who conducted the study.
Visible benefits over the long term
“This study clearly demonstrated that there is a long-term benefit in preventing serious cardiac events by clearing all arteries. There were also no major downsides to these additional procedures,” he continues. And to clarify: “The benefits appeared in the long term and were similar when the additional interventions were carried out during the first 45 days following the heart attack”.
Every year in France, 40,000 to 50,000 people die of cardiac arrest, i.e. about 130 per day. Nevertheless, according to a recent study also presented at the Congress of the European Society of Cardiology, the increasingly frequent use of cardiopulmonary resuscitation would have saved more lives.
Regarding the symptoms, they are more characteristic in humans. According to French Federation of Cardiology“nearly half of women under 60 who have suffered a myocardial infarction did not experience the classic symptoms”. The classic signs of a heart attack include a feeling of heaviness or pressure in the chest, pain radiating to the neck and jaw, back and/or left arm, sweating, nausea and/or vomiting, shortness of breath or dizziness and/or fainting.
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