Delaying in placing a stent – a meshtube placed in artery to improve blood flow – in patients who have suffered a ‘high risk’ heart attack could aid their recovery,a new research has claimed.
The usual procedure in patients who have suffered a ST segment elevation myocardial infarction (STEMI) ‘heart attack in which the coronary artery is totally blocked’ and who are at risk of ‘no reflow’ is to immediately insert a stent to reopen the blocked artery.
But,a study by Professor Colin Berry and colleagues at the University of Glasgow and the Golden Jubilee National Hospital,presented to the American College of Cardiology (ACC) on March 9,found deferring stenting in such cases was beneficial.
A STEMI heart attack occurs when the coronary artery is totally blocked resulting in prolonged interruption to the blood supply if not treated promptly.
‘No-reflow’ is a phenomenon where,although blood flow through the blocked artery is restored,blood still cannot return to the oxygen-starved area of the heart.
About 40 per cent of people who have had a STEMI heart attack are at risk of ‘no reflow.’
The study,funded by the British Heart Foundation (BHF) and the Chief Scientist Office of NHS Scotland,involved 101 patients who had suffered a STEMI heart attack and were at high risk of ‘no reflow.’
In one group of patients the researchers inserted a stent straight away,and in the other stenting was delayed. Prof Berry,of the Institute of Cardiovascular and Medical Sciences and Honorary Consultant Cardiologist at the Golden Jubilee National Hospital said,”we are really excited about the potential clinical impact of our trial results.”
The evidence suggests that no-reflow and thrombotic events were reduced with deferred stenting.
Deferred stenting means there is a period of time where a healing process of sorts can take place.
When the stent placement is deferred,it is placed in better circumstances.
However,bigger trials with a lengthier follow-up of patients would be needed before there is a change in clinical practice.