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Study questions angioplasty use in some patients


5 Star

Study questions angioplasty use in some patients

Our Review Summary

This is a well written story about a study that raises concerns about the use of angioplasty and stenting for the treatment of patients who have had a heart attack more than 12 hours before and are no longer experiencing chest pain (angina).  It lays out current medical practice and the rational for this practice; it then explains the nature of the data demonstrating that for this particular group of patients, the more invasive intervention is no better in preventing future heart attacks, heart failure, or death than treating these patient only with the medication they would receive after the intervention.

 The story provides useful insight into the importance of clinical trials, even for treatments that the experts 'believe' to be best. 


Does the story adequately discuss the costs of the intervention?


 The estimated cost for having a stent placed in a coronary artery was mentioned.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


The benefits of the two treatments in terms of reducing the risk of heart attack, heart failure, or death in this particular patient group (individuals who had had a heart attack more than 12 hours before and were no longer experiencing angina) were found not to differ as reported in the story.

Does the story adequately explain/quantify the harms of the intervention?


The harms associated with the use of drug coated stents were presented in this story.  The reader needed to infer that a harm associated with stents was the propensity of the artery to "close again".  Ideally, a story should mention both the frequency and severity of adverse effects.  But since the focus of this story was on a study showing that the rates of heart attack and death were comparable for different approaches  ("either heart medicines only or balloon treatment and stents with heart medicines"), we consider this as satisfactory.



Does the story seem to grasp the quality of the evidence?


The story described the design of the study, presented the results of the study and explained the significance of the observations.

Does the story commit disease-mongering?


No obvious elements of disease-mongering.

Does the story use independent sources and identify conflicts of interest?


The first author of the study discussed, the director of the NIH institute funding the study, and an expert in the field not associated with the study all appeared to be sources of information for this story.

Does the story compare the new approach with existing alternatives?


The story presented the treatment options following a heart attack as a balloon treatment (angioplasty) and stent along with optimal medical management OR optimal medical management alone that were discussed in the study outlined.

Does the story establish the availability of the treatment/test/product/procedure?


It's clear from the story that this is a widely used procedure. 

Does the story establish the true novelty of the approach?


The treatment discussed in the story is not a novel treatment nor was it portrayed as such.

Does the story appear to rely solely or largely on a news release?


This story does not appear to rely exclusively on a press release

Total Score: 10 of 10 Satisfactory


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