An alternative to angioplasty

Consider this situation: A patient comes into an emergency room with a horrible feeling of pressure in the chest or a squeezing pain that radiates down the arm. Blood tests are done, and they find abnormal levels of heart muscle enzymes, indicating that a heart attack is in progress.
An electrocardiogram suggests that the heart attack is mild. An artery is partly obstructed, but some blood is still getting through to the heart.What should the doctors do? Until now, the answer seemed clear.
They should rush the patient to a cardiac catheterisation lab for angioplasty, opening the blocked artery with a balloon and, probably, a stent. The procedure carries a slight risk of causing a heart attack, but without it, heart specialists have believed, a mild heart attack could become a deadly one.
But a new study by Dutch cardiologists finds that another option is just as effective. Doctors can give patients powerful clot-dissolving drugs and drugs to lower their cholesterol and wait to see whether the chest pains go away. If they do, no angioplasty is necessary.
The results were a surprise even to the researchers, and they are so different from the standard procedures that some leading cardiologists say they do not expect them to change medical practice in the US, at least not yet. But, cardiologists say, the study was well done and the patients had state-of-the-art care.
"I really can't criticise it," said Dr Eric J Topol, chairman of the department of cardiovasc-ular medicine at the Cleveland Clinic and one of those who does not expect many doctors to change their ways. The study involved 1,200 patients who had chest pains and had suffered mild heart attacks.
NYT News Service