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Heart Matters

Plaque Attack

Tuesday, March 8, 2005; Page HE02

Too Little, Too Late Patients rushed to a hospital during a heart attack often undergo an invasive procedure called distal microcirculatory protection to clear clogged arteries. But a study in the March 2 Journal of the American Medical Association finds the procedure does not improve long-term patient outcomes.

More than 1 million people in the United States have a heart attack each year, according to the National Heart, Lung, and Blood Institute; about half of them die.

A study says clearing small arteries with devices like the GuardWire, above, doesn't improve outcomes. (Medtronic.com)

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Going With the Flow During an angioplasty -- a common procedure in which a balloon-tipped catheter is used to clear a constricted heart vessel -- fatty deposits inside the blood vessel can break off and lodge in smaller arteries downstream. Doctors often perform distal protection, using guidewire and a catheter, to clear these smaller blockages.

But researchers found that within six months, patients who received distal protection had subsequent heart attack and death rates nearly equal to those in a control group, said lead study author Gregg W. Stone, a professor of medicine at Columbia University Medical Center in New York.

"We found [that] we were able to retrieve about three-quarters of the [blockage] material," Stone said. "But it made no difference in patient outcomes."

End of an Era The study, conducted at 38 institutions in seven countries, involved 501 men and women, roughly half of whom had the procedure.

"Even though we can capture [fatty arterial plaque] and remove it, it's just too little, too late," Stone said, to offset damage from the heart attack. The finding, he said, would make it unlikely that doctors would continue doing the procedure.

-- January W. Payne

© 2005 The Washington Post Company


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