2023-10-31 23:04:32
Despite clear evidence that angioplasty (also known as “balloon angioplasty”) and stenting have minimal benefit, angioplasty and stent placement are not recommended for patients with non-emergency coronary artery disease. The technique is still frequently used. For example, angioplasty does not prevent heart attack or death, but as many as 90% of patients mistakenly believe that angioplasty reduces the chance of a heart attack. But at the same time, cardiologists are not stupid, and those who recommend patients to receive stents and those who perform the surgery do not believe this. So why do they do this?
Focus groups with cardiologists have documented the knowledge-behavior gap. They recommend and perform PCI (angioplasty and stent) despite knowing there is evidence to the contrary because they somewhat believe it will help patients in some unclear way. Doctors tend to defend this approach which is not supported by evidence and I know the data shows no benefit from this approach but they focus on how easy it is to do the procedure and think open arteries are better even though this is actually It will not affect the treatment effect while minimizing risks. I mean, the fatality rate for this surgery is only 1/150.
It may also be that doctors know too little about the relevant statistics and cannot adequately inform patients. Regardless, what we are facing now is a communication failure. So we developed some tools. For example, a sample informed consent form that lists potential benefits and risks, and even lists how many surgeries your doctor performs and your out-of-pocket costs. But please note that there are still many blanks to fill in. What are the specific numbers?
The Mayo Clinic has proposed some prototype decision-making tools. In terms of benefits, can placing a stent in the heart prevent a heart attack or death? The answer is no, stents do not reduce the risk of heart attack or death. But after a week, people who received stents said they at least felt better. However, after a year, even the symptom relief benefit was gone. It seems that the benefit of this treatment is temporary relief of chest pain, so what are the risks?
During stent surgery, two out of every 100 people will experience bleeding or damage to blood vessels, and one will experience more serious complications such as heart disease, stroke, or death. In the first year after the stent was implanted, three patients experienced bleeding episodes because they needed to take blood thinners to prevent problems with foreign objects in the heart. The treatment didn’t always work, and two patients had stents that became clogged, leading to heart attacks.
What does the world’s number one bracket manufacturer think about this? They acknowledge that evidence shows that stents do not extend people’s lives, but that longevity is overestimated. They’ll say: Look, if all we cared about was living longer, then the entire discipline of medicine would disappear, so why go to the dentist? The difference, of course, is that 80% of dental patients don’t believe that fillings will save their lives, just like they mistakenly believe that braces will save lives, and the probability of something going wrong at the dentist is not even 1%.
Stent companies actively mislead through this type of : “Open your heart, open your life,” “The door to life is wide open,” “Freedom starts here.” Their TV ads mentioned some side effects, it turns out they missed others, but more importantly, they gave the wrong impression that stents were more than just expensive and risky Band-Aids for temporary symptom relief. But what’s wrong with relieving symptoms? Look at those smiling faces. Even if the benefit is only symptom relief and doesn’t last long, what’s the problem if people think the benefits outweigh the risks?
What if I told you that even symptom relief might just be an elaborate placebo effect and you could get the same relief with a sham surgery; then, is there really no benefit to such a treatment? Let’s see what science says in the next article.
For the English report, please see the English version of The Epoch Times:Angioplasty Heart Stent Risks Versus Benefits。
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Editor in charge: Li Fan
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