Doctors may soon change the way they treat heart attacks in older adults after a major international study found that treating all major blocked heart arteries can lead to much better outcomes.
For many years, doctors usually opened only the artery that directly caused the heart attack, believing that a more limited procedure was safer for elderly patients. The new research suggests that a more complete treatment could help many older people live longer and avoid future heart problems.
A heart attack happens when blood flow through one of the heart’s arteries becomes blocked. Without enough oxygen, part of the heart muscle begins to die. Quick treatment is essential because restoring blood flow as soon as possible can reduce damage and improve survival.
Many people who have a heart attack have more than one blocked artery. Until recently, doctors often treated only the artery responsible for the emergency, sometimes called the ‘culprit’ artery. They worried that opening additional arteries during treatment could increase the risk of complications, especially in older adults who often have other medical conditions.
The new study was led by Dr. Simone Biscaglia from Ferrara University Hospital in Italy. His team wanted to find out whether treating every major blocked artery would provide greater benefits than fixing only the artery that caused the heart attack.
The researchers studied 1,445 patients who had heart attacks, with about half of the participants aged over 80 years. Some patients received treatment only for the artery that triggered the heart attack, while others had all of their major blocked arteries opened in a procedure known as complete revascularization.
The results showed a clear advantage for the more complete treatment. Patients whose doctors opened all major blocked arteries had a 36% lower risk of dying or having another heart attack within one year. When researchers combined several major outcomes, including death, another heart attack, or the need for another procedure, the overall risk was reduced by 27%.
Heart experts who were not involved in the research said the findings are important. Dr. Gregg Fonarow from UCLA noted that earlier studies mainly included younger patients, while this research demonstrates that older adults also benefit from complete treatment.
Dr. Gaurav Rao, a cardiologist in New York, agreed that treating all significant blockages gives older patients better long-term results.
The findings challenge the long-held belief that a less aggressive approach is safer for elderly people. Instead, the study suggests that age alone should not prevent doctors from considering complete treatment when several important heart arteries are blocked.
Researchers believe the results could influence future medical guidelines around the world. If adopted, more older patients may receive complete artery treatment after a heart attack, helping lower the chances of future heart attacks, repeat procedures, and early death.
Although doctors will still need to consider each patient’s overall health before deciding on treatment, this study provides strong evidence that many older adults can benefit from a more complete approach. The research was published in the New England Journal of Medicine and was also presented at the European Society of Cardiology meeting in Amsterdam.
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