Game Changer: Surgery For Blocked Arteries May Not Actually Be Necessary

Newly Released Research Upends Years of Clinical Practice

Dr. Hesham A. Hassaballa
3 min readNov 18, 2019


Photo by Piron Guillaume on Unsplash

Someone has an abnormal stress test, indicating a lack of blood flow to the parts of the heart under stress. Often times, the next step recommend by the Cardiologist is a cardiac catheterization, or angiogram. This is a picture of the arteries that supply blood to the heart. If there is a blockage, then something is done to fix it.

This coronary intervention, as it’s called in the business, is either a stent — a wire scaffolding that keeps the artery open — or sometimes, open heart surgery. It’s been accepted practice for a long time. As an ICU specialist, I frequently see such patients after their procedures in my ICU. Yet, was it really necessary? New research seems have to said, “Perhaps not.”

In brand new research presented at the annual meeting of the American Heart Association in Philadelphia, researchers said:

The trial showed that heart procedures added to taking medicines and making lifestyle changes did not reduce the overall rate of heart attack or death compared with medicines and lifestyle changes alone.

The same is true with those patients with chronic kidney disease.

The study was large (over 5000 patients were enrolled), randomized (the scientific gold standard), very well-conducted, and enrolled patients in several countries. The results were eagerly awaited, and they are truly a game changer. According to an article in The NY Times, “the nation could save more than $775 million a year by not giving stents to the 31,000 patients who get the devices even though they have no chest pain…

Is a stent necessary after an abnormal stress test? New research says, “Perhaps not.”

Now, there were important caveats to these study results. These results do not apply to those patients having an actual heart attack. Evidence clearly shows that stents save lives in acute heart attacks. The results of this study only applies to those with stable symptoms. In fact, as researchers said, “The more chest pain to begin with, the more symptoms improved after getting a stent or…



Dr. Hesham A. Hassaballa

NY Times featured Pulmonary and Critical Care Specialist | Physician Leader | Author and Blogger | His latest book is “Code Blue,” a medical thriller.