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Hamilton cardiologist says opening more arteries after heart attack reduces risk of dying

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A worldwide study, led by a Hamilton cardiologist, suggests that taking the time to open all the blockages during heart surgery is better than treating only the one blockage. Getty Images

A McMaster University professor who led a worldwide study says opening all clogged arteries after a serious heart attack is better than just tackling the artery that caused the heart attack.

Dr. Shamir R. Mehta, a professor with McMaster’s Population Health Research Institute (PHRI) and a cardiologist with Hamilton Health Sciences, says the study shows that half of all heart attack victims typically have other clogged arteries in addition to the one that caused their heart attack.

Mehta says doctors typically focus on opening the artery responsible for the heart attack, leaving the other blockages for treatment with medication alone.

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However, the collaboration with 130 hospitals in 31 countries suggests that taking the time to open all the blockages during surgery is better than treating only the one blockage. The study revealed a 26 per cent reduction in a patient’s risk of dying or having another heart attack with the extra work.

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“This study clearly showed that there is long-term benefit in preventing serious heart-related events by clearing all of the arteries. There was also no major downside to the additional procedures,” said Mehta.

“Given its large size, international scope and focus on patient-centred outcomes, the complete trial will change how doctors treat this condition and prevent many thousands of recurrent heart attacks globally every year.”

The study, funded by the Canadian Institutes of Health Research, revealed the involvement of just over 4,000 patients in a randomized trial.

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“The benefits emerged over the long term and were similar when the additional stent procedures were done any time in the first 45 days after the heart attack,” Mehta said.

The chances of a second heart attack or cardiovascular death dropped to 7.8 per cent in patients who had the complete revascularization during the three years of the study. That’s compared to 10.5 per cent of those who had a stent only for the artery that caused the first heart attack.

Mehta says the benefit was more sizable when factoring in unexpected events such as severe chest pain requiring a patient to “have a repeat stenting procedure.”

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