New research suggests that clearing all major heart arteries, not just the one causing a heart attack, could be a lifesaver for elderly patients.
Currently, doctors often focus on opening only the “guilty” artery that led to the heart attack.
This cautious approach is mainly due to concerns about complications, particularly because older patients often have other health conditions.
Dr. Simone Biscaglia, the lead researcher and an interventional cardiologist at Ferrara University Hospital in Italy, said the new findings could revolutionize how heart attacks in older patients are treated.
“What we found is the exact opposite of what we used to think,” Biscaglia stated. He explained that treating all significantly blocked arteries should be the new standard, even for older patients.
New Study, Significant Findings
In the study, 1,445 patients, half of whom were over 80, were either treated to unblock only the main artery causing the heart attack or to open all major blocked arteries.
The results were striking: the risk of dying or having another heart attack within a year dropped by 36% for those who had all their blocked arteries treated.
When looking at all the outcomes together—death, another heart attack, or needing another procedure—the risk dropped by 27% for patients who had all their major arteries cleared.
“The complete revascularization strategy in heart attack is superior to a culprit lesion-only approach in patients age 75 or older,” affirmed Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles.
Fonarow mentioned that while previous trials were mostly focused on younger patients, this study establishes that the benefits extend to an older demographic.
Implications for Medical Practice
These findings provide more evidence supporting a treatment approach already used in younger patients, according to Dr. Gaurav Rao, an interventional cardiologist at Northwell Atlas Bass Heart Hospital in Manhasset, N.Y. Rao said that the study has practical implications:
“Older patients are going to benefit from complete revascularization rather than fixing only the culprit vessel, and they are going to do better in the long run.”
Given these promising results, experts are pushing for a shift in the standard of care to include complete revascularization for all patients, regardless of age, who suffer from heart attacks and have multiple blocked arteries.
The study, which adds more weight to the growing consensus, was published online in the New England Journal of Medicine and presented at the European Society of Cardiology meeting in Amsterdam.
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The research findings can be found in the New England Journal of Medicine.
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