Topeka doctor offers perspective on study questioning stents

TOPEKA, Kan. (WIBW) - Hundreds of thousands of people each year get a stent to open a blocked coronary artery.

Dr. Jack Jones, a cardiologist at Topeka's Stormont Vail, says they work well.

"It does what it's designed to do which is open up the artery and improve blood flow," he said.

But a study published last fall found stents did little to improve angina, or chest pain. The result had some in the medical community questioning if the procedures were overdone. But Jones says the study needs a closer look.

"These patients (in the study) were very low risk," he explained.

Jones says the patients in the study had stable symptoms, usually exercise-induced, with a single vessel blockage, and were already on an optimal, intense medication therapy.

"When they had that group of patients who were well-controlled, had stable symptoms that occurred only with vigorous activity, then coronary stents were shown not to significantly increase their exercise time," he said.

Jones says the study did not look at unstable patients, which would include those having a heart attack or at high risk for one with multiple blocked vessels.

"Patients that are unstable, we know that they need to be fixed," Jones said. "They need to have their blood flow restored with either stents or another procedure."

Even in stable patients, Jones says the option for a stent may still be on the table because avoiding a procedure takes commitment.

"Unfortunately, most people don't like to take a lot of pills; they don't like to quit smoking; or they don't like to exercise and lose weight," he said. "Optimum medical therapy works, but it's a very intensive regimen that includes a lot of lifestyle modifications and also a lot of medications."

Jones said he hopes the study does not discourage people from seeking help when they have chest pain. He says those symptoms need to be evaluated to find what's causing it.