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President Bush’s Overtreated Heart – Part 2

December 15, 2013
By

A colleague read my post on President Bush’s stent and thought it might be a good idea to describe the potential harms of a stent. He is a wise man, and his name is Larry Bauer, PhD. He is the CEO of the Northeast Family Medicine Education Consortium. Both he and his organization are playing a vital role in promoting innovation in family medicine and helping better tell the story of family medicine to the general public. So here we go…

A recent meta-analysis of stents for stable coronary heart disease/angina found that after an average follow up of 4.3 years, here are what people with stable angina can expect WHETHER OR NOT THEY GET A STENT:

  • 9% will die
  • 8% will have another nonfatal heart attack
  • 26% will have an unplanned coronary artery procedure such as another stent or bypass surgery
  • 69% will have significant relief of their angina
  • 31% will still have anginal symptoms, though they won’t be as severe

Having a drug-eluting stent means that the President will have to take aspirin and clopidogrel (Plavix) for at least 9 months. This puts him at increased risk of major bleeding (about one percent over a year compared to aspirin alone), but not life-threatening bleeding. Plus, there is the cost of the clopidogrel that would not be necessary if he had medical treatment without the stent.

Once again, a review of the evidence finds that President Bush’s stent is a classic case of a complete waste of medical resources, both the testing that led to the discovery of his heart vessel disease and the procedure itself. Wouldn’t it be great if the President figured this out, then led the fight to prevent others from suffering the same fate? I’m not holding my breath.

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