Heart stents do little to relieve chest pain, U.K. researchers find

A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them, researchers reported Wednesday.

Their study focused on the insertion of stents, tiny wire cages, to open blocked arteries. The devices are lifesaving when used to open arteries in patients in the throes of a heart attack.

But they are most often used in patients who have a blocked artery and chest pain that occurs, for example, going up stairs.

The new study, published in the Lancet, stunned leading cardiologists by countering decades of clinical experience. The findings raise questions about whether stents should be used so often — or at all — to treat chest pain.

Dr. William E. Boden, a cardiologist and professor of medicine at Boston University School of Medicine, called the results “unbelievable.”

For the study, Dr. Justin E. Davies, a cardiologist at Imperial College London, and his colleagues recruited 2 00 patients with a pro - foundly blocked coronary artery and chest pain severe enough to limit physic al activity, common reasons for inserting a stent.

All were treated for six weeks with drugs to reduce the risk of a heart attack, like aspirin, a statin and a blood pressure drug, as well as medications that relieve chest pain by slowing the heart or opening blood vessels.

Then the subjects had a procedure: a real or fake insertion of a stent.

In both groups, doc- to rs threaded a catheter through the groin or wrist of the patient and, with X-ray guidance, up to the blocked artery. Once the catheter reached the blockage, the doctor inserted a stent or, if the patient was getting the sham procedure, simply pulled the catheter out.

Neither the patients nor the researchers assessing them afterward knew who had received a stent. Following the procedure, both groups of patients took drugs to prevent blood clots.

When the researchers tested the patients six weeks later, both groups said they had less chest pain, and they did better on treadmill tests. But there was no real difference between the patients, the researchers found. Those who got the sham procedure did just as well as those who got stents.