Most angioplasties are unnecessary, study finds

The study renewed a heated animosity between doctors who perform angioplasty and other heart specialists.

In fact, one who does the procedures and who spoke at a meeting in New Orleans sponsored by stent maker Boston Scientific Corp. was responsible for the early release of the study’s results, which were not due out until Tuesday.

'Rigged to fail'
The study “was rigged to fail, and it did,” the Wall Street Journal quoted Dr. Martin B. Leon of Columbia University telling several hundred of his colleagues Sunday night.

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“A lot of people have been taking shots at us, and we need to go on the offense for awhile,” the Journal reported Leon said.

He claimed to have inside knowledge of the results because he reviewed the study for the New England Journal. The journal would not comment, saying the identity of its reviewers is confidential.

The cardiology college issued a statement saying it was “extremely disappointed” results were released prematurely, “betraying the confidentiality of the scholarly process and the professional integrity of the scientific community.”

The college “will be considering strong sanctions against the individual or individuals involved,” the statement said.

Dr. Spencer King of Piedmont Hospital in Atlanta, a leading cardiologist who does many angioplasties, said he was disappointed in the study results.

“How many patients have interventions in which the only expectation is to reduce the use of nitroglycerin or to walk a bit faster? Most patients anticipate a better prognosis and might opt for an extended course of medical therapy if they believe they are not putting their life at excess risk,” he wrote in a recent editorial in an American Heart Association journal.

In an interview at the cardiology meeting, King said he recently had surgery for back pain and did not expect permanent relief but added, “If it only held up for five years, I wouldn’t be happy about it.”

The new study “should lead to changes in the treatment of patients with stable coronary artery disease, with expected substantial health care savings,” Dr. Judith Hochman of New York University wrote in an editorial in the journal.

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Angioplasty costs $30,000 to $40,000. The drugs used in the study are almost all available in generic form.

Maron, the Vanderbilt doctor who helped lead the study, said people should give the drugs a chance.

“Often I think that patients are under the impression that unless they have that procedure done, they’re not getting the best of care and are at increased risk of having a heart attack and die,” he said.

Dr. Raymond Gibbons, a Mayo Clinic cardiologist and American Heart Association president, agreed: “This trial shows convincingly that that assumption is incorrect.”

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