The Truth About Angioplasty and Bypass Surgery
Julian Whitaker, MD
If you’ve ever had a heart attack or recurring angina, chances are you’ve either had or been recommended to have an angioplasty (or, as it’s now called, percutaneous coronary intervention—or PCI). This procedure involves inflating a balloon on the tip of a catheter inserted into a narrowed artery. Performed more than a million times a year, angioplasty is the standard of care for patients who have had a heart attack. It is also a popular therapy for many who are suffering with angina and for asymptomatic patients with blockages in the coronary arteries.
But there’s a problem. Contrary to popular belief, angioplasty does not prevent heart attacks or save lives.
Studies Show Harm
Conventional wisdom dictates that angioplasty is best done within 12 hours after a heart attack, but at least a third of patients are not treated within that time frame. Nevertheless, “late” angioplasty is routinely performed on the assumption that it provides benefit. Well, it doesn’t.
A large, multi-center study published in the New England Journal of Medicinerevealed that when angioplasty was done three to 28 days after a heart attack, it failed to reduce the occurrence of death, repeat heart attacks, or heart failure. Even worse, during four years of follow-up there were more heart attacks in the group that had angioplasty, compared to those treated conservatively with drugs.
Another major drawback of angioplasty is restenosis, or closing up of the opened artery. To counter this, a tiny metal “scaffold” called a stent is usually placed in the artery to keep it propped open. But even stents can become blocked with scar tissue over time, so most are coated with drugs to reduce this risk.
While this may sound like a good idea, three new studies show that it’s anything but. Although drug-coated stents may decrease restenosis, they interfere with the creation of collateral circulation that naturally bypasses blocked arteries, increase risk of potentially fatal blood clots—and more than double the risk of heart attack or death!
Even the FDA Warns of Risks
The FDA recently convened an expert panel to look at the safety of drug-eluting stents, and they concluded that these stents are safe and effective only when used as originally approved: in patients with one blocked artery and no significant heart damage.
Well over half of all drug-eluting stents are implanted in patients who do not meet these criteria. The panel warned physicians to be more discriminating and judicious in their use of these stents, stating that, in many patients, they increase risk of blood clots, heart attacks, and death from heart disease.
Cardiologists are not likely to pay much attention to this. I predict that business will continue as usual, but the hundreds of thousands of stent recipients will be forced to take Plavix, a drug that helps prevent blood clots, for the rest of their lives—at a cost of $1,400 a year. That’s great news for stent and drug manufacturers, but it’s bad news for you.
“Cures” Worse Than the Disease
Angioplasty, bypass, and other invasive heart procedures not only do not, but cannot, prevent heart attacks or prolong lives in the vast majority of patients who have them.
Way back in 1983—long before angioplasty became the revenue-generating darling of cardiology—the Coronary Artery Surgery Study (CASS) was published. This definitive clinical trial was expected to confirm the benefits of bypass surgery in patients with significant heart disease.
Instead, CASS showed that bypass was a bust. Rates of heart attack and death from heart disease were no lower in patients who had surgery than they were in a similar group of patients treated without surgery. The death rate in the patients who didn’t have bypass surgery was a surprisingly low 1.6 percent per year. The chance that any surgery will improve upon a death rate this low is virtually nil. It boils down to one indisputable fact: You cannot save the life of someone who is not going to die.
This Study Is Relevant Today
The findings from this study are as relevant today as they were more than two decades ago. At the time of the CASS trials, the death rate of patients 65 and older hospitalized for bypass was 11 percent. While the in-hospital death rate for bypass has dropped to 2.2 percent (this includes all age groups; it’s higher for older people), the annual mortality rate for patients with heart disease treated with noninvasive methods has fallen below 1 percent—meaning you’re still more than twice as likely to die from the surgery as you are from the disease.
I’ve said for decades that a middle school math student could take these figures and determine that the current use of invasive heart procedures is fraud. When you weigh the certain pain and cost of surgery against the slim chance of benefit, it’s an easy call. Yet today, bypass, angioplasty, and other “lifesaving” heart procedures continue to be foisted upon more and more folks who don’t need them.
Follow the Money
If hard science and patient benefit were central factors at work here, these procedures would be a rarity. But invasive cardiology has nothing to do with science. It has nothing to do with saving lives or improving quality of life. It has to do with money. Period!
According to the American Heart Association, every year in US hospitals, 1,414,000 cardiac catheterizations (angiograms) are performed at an average cost of $24,893; 1,244,000 angioplasties at $38,203 each; and 467,000 bypass surgeries at $83,919 per operation. These procedures generate more than $121 billion a year, a windfall that makes up approximately 45 percent of the total revenue of most hospitals!
That’s why angioplasty and bypass remain popular, despite dozens of studies that have been conducted over the past quarter-century—not one of them showing that either of these procedures prevents heart attacks or premature death for the overwhelming majority of people.
Scared Into Surgery
The millions of patients required to fill beds in cardiac care centers across the country are not that hard to come by. All a heart surgeon or interventional cardiologist has to do is tell them, “If we don’t operate, you’re going to die in the parking lot.” Presto! Grossly misinformed and frightened, people quickly embrace these “lifesaving” therapies.
One such patient is Health & Healing subscriber Lee Larson of Arizona City, AZ. Lee is a heart surgery veteran. Back in 1997, he had a heart attack and underwent angioplasty. Within months, his angina returned, and he was told the artery had closed up. So he had another angioplasty, then another. He finally ended up having a bypass. Despite all this, Lee was unable to walk more than half a block before severe chest pain and pressure forced him to stop and rest. Realizing that the route he was on wasn’t working, he decided to come to the Whitaker Wellness Institute.
You Do Have Options
At the clinic we treated Lee as we treat all of our patients who have heart disease. We started him on a therapeutic diet and a mild exercise program. He underwent a course of enhanced external counterpulsation (EECP) and hyperbaric oxygen therapy (HBOT) to restore blood flow and help build collateral circulation. He began taking multiple supplements to address the underlying causes of heart disease, including fish oil to counter inflammation, red yeast rice and policosanol to lower his cholesterol, nattokinase to improve blood flow, and coenzyme Q10 to strengthen his heart.
Today, Lee rides his bicycle five to 15 miles a day and walks on a treadmill for 30 minutes at a nine percent incline without chest pain or pressure. He has lost 25 pounds and states that he feels better than he has in 10 years.
Look Before You Leap
We see patients with improvements as dramatic as Lee’s every day. It’s not that hard to help them—we simply go back to the basics. Heart disease is systemic, not localized to a specific artery. The condition is multi-factorial, not just about cholesterol and blood pressure, and it is best treated by addressing all of the factors that increase risk of heart attack.
The most disheartening aspect of the bypass-angioplasty charade is that it prevents people from receiving appropriate care. Going after blockages with stents or bypass is not the answer. It just gets in the way, frequently making the situation worse. In reality, if we tied the thumbs of all catheter-pushing cardiologists and heart surgeons, the death rate from cardiovascular disease would decline dramatically.
- You need to think this invasive cardiology issue through now, not when you’re lying in the ER with a doctor telling you you’re going to die if you don’t do something right away. To learn more, read my book Reversing Heart Disease. It is available in bookstores, online at the Whitaker Wellness online store, or by calling (800) 810-6655.
- To learn more about the Whitaker Wellness Institute’s safe, noninvasive approach to treating heart disease, contact a Patient Services Representative at (866) 944-8253 or click here.
- Hochman JS, et al. Coronary intervention for persistent occlusion after myocardial infarction. N Engl J Med. 2006 Dec 7;355;23:2395–2407.
- Eisenstein EL, et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA. 2006 Dec 5; [Epub ahead of print].
- Hochholzer W, et al. Impact of the degree of peri-interventional platelet inhibition after loading with clopidogrel on early clinical outcome of elective coronary stent placement. J Am Coll Cardiol. 2006 Nov 7;48(9):1742–1750.
- Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery. Survival data. Circulation. 1983 Nov;68(5):939–950.
Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2007. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.