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LifeBeat ExplanationA coronary artery is a blood vessel that carries blood to the heart muscle. It can be blocked by plaque. Plaque is a build-up of fatty materials, calcium, and/or cell debris. An angioplasty is when a tiny balloon is passed into the blocked area of the artery. When the balloon is inflated, it presses the plaque against the blood vessel wall. This frees the blood flow in the artery. During an angioplasty, a stent can also be inserted. A stent is a metal mesh tube that helps keep the artery open so blood can flow freely. |
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From the Summer 2003 Issue
Cardiovascular News
Help for Heart Attack Survivors
Every year, 1.1 million cases of heart attack occur in the United States. During a heart attack, the heart receives less oxygen than it needs. But what causes a heart attack? Heart attacks can be the result of coronary artery disease (CAD). In CAD, a build-up of fat or plaque within the artery makes blood flow difficult. The build-up can even result in a blockage of the artery. If the heart's blood supply is severely reduced or cut off, part of the heart muscle may die. If part of the heart muscle dies, the person is said to be experiencing a heart attack.
Until now, the widely accepted treatments for CAD have been bypass surgery and balloon angioplasty. However, a breakthrough study shows that heart attack survivors can benefit from angioplasty followed by the insertion of a stent. This study is called the CADILLAC study. We spoke to Gregg Stone, MD, a lead researcher for CADILLAC. He helped us understand the study a bit more.
CADILLAC stands for Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications. What does this really mean? This means that the study looked at the use of abciximab (a clot-busting drug) and stents in reducing heart problems after angioplasty.
The Study
The CADILLAC study looked at more than 2000 patients in 76 cardiology centers around the world. It compared four different types of treatments:
- Angioplasty alone
- Angioplasty with clot-busting drugs
- Angioplasty with stent
- Angioplasty with stent and clot-busting drugs
The Results
The patients who received angioplasty and a stent did better than the patients who received angioplasty alone. They were less likely to have recurring chest pain. And they were also less likely to need another procedure. Clot-busting drugs also helped in the short term.
After 6 to 12 months, patients with stents did much better than patients who had angioplasty alone. CADILLAC showed that heart attack patients implanted with stents within 12 hours of an attack had a nearly 50% reduction in major cardiac events compared with patients who had angioplasty alone. This means a nearly 50% reduction in death, future heart attack, stroke, and recurring vessel blockages compared with patients who had angioplasty alone.
What Do These Results Mean to Me?
The results of this study are very good for patients who suffer heart attacks. Years of research show that angioplasty, alone, can be very effective. Dr. Stone says, "Angioplasty saves lives. It prevents later heart attacks, and reduces stroke and major bleeding." But, according to CADILLAC, implanting stents during angioplasty provides even better results for many patients.
Dr. Stone continues, "The CADILLAC trial establishes a new standard for heart attack survivors. Patients should be getting balloon angioplasty, followed by a stent." Now, if a patient with a heart attack is at a hospital skilled in angioplasty, a stent should be considered sooner. This is in addition to angioplasty.
So if you feel as though you are experiencing the symptoms of a heart attack, don't hesitate. Get yourself checked out quickly. And consult with your doctor to find the best options for you.