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August 2011

Cardiologists Continue Unnecessary Surgeries

Surgically implanting stents to "unblock" arteries is a $12B business.   That's billion with a B.  Are they effective 24 hours after a heart attack?

No.  Drug therapy is better. Ab


In 2006, Dr. Judith Hochman published a study known as the Occluded Artery Trial showing that stents did not prevent any deaths or new heart attacks compared with drugs alone when inserted more than 24 hours after a heart attack into a totally blocked artery.

So the American Heart Association published guidelines in 2007 recommending against the use of stents more than 24 hours after a heart attack.

So of course the use of stents by cardiologists decreased dramatically, right?

Wrong.

Turns out there was no difference in usage of stents according to a study in the Archives of Internal Medicine.

The procedure costs $20,000 and 50,000 people get it, who shouldn't.  That's $1B a year wasted.  And that doesn't include the cost of complications from surgery (like throwing a clot and causing a stroke, or hospital acquired infections). 

I'm not sure why this is.  Could it be that these cardiologists are:
a) too busy or lazy to keep up with best practices in their field?
b) are smarter than the American Heart Association?
c) need the extra money?
d) don't put the patient's needs first?

I don't know.  But remember we all pay for this through our taxes or our employers are paying for it. 

Put it a different way: If you have a clogged sink would you rather pay $10 for a bottle of Draino or $1,000 to a plumber to replace the pipes.  Both fix the problem.

That's not healthcare rationing, it's common sense.