When someone has a heart attack, doctors need to act fast. A heart attack happens when a coronary artery—one of the blood vessels supplying the heart—gets blocked, usually by a blood clot.
To save the heart muscle, doctors must quickly open the blocked artery using a stent, a small tube that helps keep the artery open.
But what should doctors do if, during the emergency procedure, they find that other arteries are also narrowed? A new study from Radboud University Medical Center in the Netherlands has found that it is safe to wait and treat those other arteries later. This approach can reduce the number of stent procedures by half.
Each year, around 33,600 people are admitted to hospitals with heart attacks. Doctors usually perform a procedure called angioplasty to open the blocked artery and prevent lasting heart damage.
During this procedure, they sometimes discover that other arteries are also partly blocked. Until now, guidelines have recommended treating all of the narrowed arteries during the same procedure.
Researchers from 41 hospitals, led by Radboudumc, studied whether it is better to treat the additional blockages immediately or to wait. They followed 1,146 patients who had an acute heart attack, which means that one of their arteries was completely blocked.
Half the patients had all narrowed arteries treated during the first procedure. The other half had only the blocked artery treated at first, and the rest were treated up to six weeks later, if needed.
After three years of follow-up, the researchers found no difference between the two groups. The patients had similar rates of death, new heart attacks, and hospital admissions for heart failure.
Professor Robin Nijveldt, a heart imaging specialist at Radboudumc, said, “We saw no difference in long-term outcomes between patients who received immediate full treatment and those who waited.”
One of the most surprising results was that doctors ended up putting in only half as many stents during the later follow-up phase.
Professor Niels van Royen, a cardiologist involved in the study, explained that this is because doctors can use better tests later on, such as MRI scans, to see how much blood is reaching the heart. If the heart is still getting enough oxygen, even through a narrowed artery, a stent might not be necessary after all.
Van Royen noted that while it’s sometimes more convenient for patients to have all procedures done at once, that’s not always possible. “If the patient is tired or another emergency comes in, we now know it’s safe to stop and finish the treatment later,” he said. “Faster doesn’t always mean better.”
Later on, patients can have an MRI scan to check their heart function. If the scan shows good blood flow, they may not need more stents. However, Van Royen emphasized the importance of patients returning for the follow-up scan. “Some people skip it, but they really shouldn’t,” he said.
This new research challenges current medical guidelines, which still suggest treating all blockages right away. The older guidelines were based on studies that showed small short-term benefits. But this larger, long-term study suggests that waiting doesn’t increase the risk and may actually spare some patients from unnecessary procedures.
The researchers hope their findings will help doctors make better decisions and ease patient concerns. Knowing that it’s safe to wait gives both doctors and patients more flexibility and peace of mind.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
The study is published in New England Journal of Medicine.
Copyright © 2025 Knowridge Science Report. All rights reserved.
