Around 2.3 million people live with coronary heart disease in the UK
Researchers at King’s College London have produced new evidence from a multi-centre clinical trial suggesting that high-risk heart failure patients should receive an implantable cardioverter-defibrillator (ICD) much sooner.
Funded by the British Heart Foundation (BHF), the research suggests that lifesaving ICDs should be provided to heart failure patients at the highest risk of heart rhythm straight away, rather than waiting until after stent insertion.
ICDs shock and kick-start the heart if it goes into a life-threatening rhythm or cardiac arrest.
Around 2.3 million people in the UK are living with coronary heart disease, which is the leading cause of heart failure.
Currently, doctors may first insert stents to open any blocked arteries, and patients will wait 90 days before being recommended for an ICD to see if the pumping function of the heart has improved.
In the trial, the researchers recruited 700 patients who had coronary heart disease and severely weakened function of the left ventricle of their heart from 40 hospitals across the UK.
After randomly assigning half of the patients to have stents fitted, the researchers found that stents did not improve the heart’s ability to pump, reduce the risk of heart rhythm disturbances, or reduce the number of cardiac arrests or deaths.
The researchers do still recommend stents as an effective treatment for heart attack patients or people with angina.
Dr Holly Morgan, BHF clinical research fellow, UCL BHF Centre of Research Excellence, said: “By showing that coronary stents had limited benefit for this group of heart patients, we have exposed a clear window of missed opportunity to reduce chances of dying from an abnormal heart rhythm.”
Dr Sonya Babu-Narayan, associate medical director, BHF, said: “The findings suggest that the current ‘wait and see’ approach to find out whether a patients’ heart function improves with medication and stents isn’t always best, and that an unnecessary wait could even be the difference between life and death.”
