New research is changing how doctors think about treating heart attacks in older adults.
Until now, the usual practice has been to fix only the artery that caused the heart attack. This is often called the “guilty” artery.
Doctors were cautious about doing more because older patients often have other health issues that could increase the risk of complications.
But a new study led by Dr. Simone Biscaglia from Ferrara University Hospital in Italy suggests that this cautious approach may need to change. According to the findings, it’s better to treat all major blocked arteries—not just the one that triggered the heart attack—even in elderly patients.
“What we found is the exact opposite of what we used to think,” said Dr. Biscaglia. He explained that opening all major arteries with blockages should become the new standard of care for older patients after a heart attack.
The study included 1,445 patients, and about half of them were over the age of 80. Some of the patients only had their main artery treated, while others had all major blocked arteries opened. The results were clear.
Those who had all their blocked arteries cleared had a 36% lower chance of dying or having another heart attack within a year. When looking at all major outcomes together—death, another heart attack, or needing another procedure—the risk dropped by 27%.
Dr. Gregg Fonarow, a heart specialist at UCLA, confirmed the importance of the findings. He said that previous studies mostly focused on younger people, but this study shows that older adults benefit too.
Dr. Gaurav Rao, a cardiologist in New York, also supports the new approach. He said, “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.”
This research supports a method that has already been used for younger patients and now shows it should be applied to older people as well. Experts are now calling for a change in medical guidelines to include full artery treatment for all heart attack patients who have multiple blockages—no matter their age.
The study was published in the New England Journal of Medicine and presented at the European Society of Cardiology meeting in Amsterdam.
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