Is Heart Surgery Worth It

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Highlights of July 18, 2005 BusinessWeek article

All of these are direct quotes from Business Week's July 18 article: " Is Heart

Surgery Worth It? "

* " Data from clinical trials are clear: Except in a minority of patients with

severe disease, bypass operations don't prolong life or prevent future heart

attacks. Nor does angioplasty . . . "

* " Without better trial data, we won't know if improvements in pain relief

justify the risks of the surgery. "

* " Not only is there a 1% to 2% chance of dying during a bypass operation, "

says Dr. Nortin Hadler, professor of medicine at the University of North

Carolina at Chapel Hill and author of The Last Well Person, " there is a high

risk of complications and a 40% chance of cognitive defects The healthy, active

post-surgery patient is an urban legend. An alarming number never return to the

workforce or describe themselves as well again. "

* " There are also fresh concerns about the safety of drug-coated stents, now

widely used in angioplasty. . . . people getting these new stents might have a

higher risk of clots, which could then cause heart attacks more than a month

after the procedure. "

* Says Dr. Topol of Cleveland Clinic Foundation: " Out of 100 patients who

get a drug-coated stent, maybe 10 will avoid a repeat procedure. "

* " There is compelling evidence that aggressive treatment [like heart

surgeries] are not necessarily better. . . Says professor of medicine at

Dartmouth Dr. Elliott Fisher: " We are wasting 30% of health-care spending on

stuff with no benefit and perhaps causing harm. "

* Dr. Laham of Harvard Medical School says that as many as 400,000 of the

angioplasties done in the U.S. each year may be medically unwarranted. " I'm

sure we are way overtreating our patients. "

* " A better way to lower heart-attack risk is to fight the unstable plaque with

aggressive cholesterol-reducing drug therapy, diet, and lifestyle changes, many

cardiac physicians say. "