For patients with stable angina, stents have benefits, says new study

Stents are like scaffolding that keep narrowed arteries open. These devices have been revolutionary in treating heart attacks where their use has increased year on year and countless lives have been saved. But the role of stents in patients with stable angina is less clear.

Heart arteries are like motorways supplying blood to the heart muscle. When a heart artery is narrowed by atherosclerosis it is like reducing the number of lanes from three down to one. At night, when there aren’t many cars on the road, the traffic can get through without delay. But during rush hour, when there are greater demands on the network (an analogy for exercise), traffic jams occur. This explains why patients with stable angina only get chest pain when they exert themselves.

About 35,000 patients a year are treated with stenting of the heart arteries to treat angina, yet several trials have shown that in patients with stable angina, stenting does not provide any reduction in death or heart attack rates over treatment with tablets. Nice guidelines (evidence-based recommendations for healthcare in England) therefore recommend that stenting is reserved for patients who still have symptoms despite treatment with at least two different angina drugs.

Many cardiologists have wondered if that approach is correct as...

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