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People with severe but stable heart disease from clogged arteries may have less chest pain if they get a procedure to improve blood flow rather than just giving medicines a chance to help, but it won’t cut their risk of having a heart attack or dying over the following few years, a big federally funded study found. The results challenge medical dogma and call into question some of the most common practices in heart care. They are the strongest evidence yet that tens of thousands of costly stent procedures and bypass operations each year are unnecessary or premature for people with stable disease. (Marchione, 11/16)

The findings of a large federal study on bypass surgeries and stents call into question the medical care provided to tens of thousands of heart disease patients with blocked coronary arteries, scientists reported at the annual meeting of the American Heart Association on Saturday. The new study found that patients who received drug therapy alone did not experience more heart attacks or die more often than those who also received bypass surgery or stents, tiny wire cages used to open narrowed arteries. (Kolata, 11/16)

The $100 million trial, presented Saturday at the annual meeting of the American Heart Association ahead of publication in a peer-reviewed journal, is the latest entry into a long and contentious argument over how to treat artery blockages, one that has pitted powerful factions of American heart specialists against each other. It echoes a similar study 12 years ago that was critiqued by interventional cardiologists, the doctors performing the invasive procedures. “This is a milestone study that people will talk about and write about for years to come,” said Elliott Antman, a cardiologist at Brigham and Women’s Hospital who was not involved in the study and praised it for the wealth of information gathered and the rigor and sophistication of the analyses. (Johnson, 11/16)

“You won’t prolong life,” said Judith Hochman, chair of the study and senior associate dean for clinical sciences at the New York University Grossman School of Medicine. But stents or bypass surgery work better than medicine and lifestyle changes alone in relieving symptoms for people who have frequent angina, or chest pain, the researchers found. (McKay, 11/16)

“Based on our results, we recommend that all patients take medications proven to reduce the risk of a heart attack, be physically active, eat a healthy diet, and quit smoking,” said co-chair David Maron, director of Preventive Cardiology and the Stanford Prevention Research Center at Stanford University.(Waller, 11/16)