NEW YORK (Reuters Health) - Heart attacks that are a few days to several weeks old are better treated with medications than with angioplasty, new research suggests. In the long-term, angioplasty does not improve outcomes and is much more costly.

Prior research has shown that heart attacks that are only a few hours old are best treated with angioplasty. But whether this also holds true for older attacks in stable patients was unclear.

In the current study, angioplasty with placement of a small tube or stent to keep the blocked coronary artery open slightly improved heart function at 4 months, but this benefit later disappeared. Moreover, at 2 years, patients who underwent stenting had a marginally shorter survival, accounting for quality of life, when compared with medical therapy.

"The finding is just one more reason to question the use of routine (angioplasty and stenting) in late-treatment patients when cheaper, less invasive options are just as effective," lead author Dr. Daniel B. Mark, from Duke University Medical Center, Durham, North Carolina, said in a statement.

As reported in The New England Journal of Medicine, Mark's team assessed quality of life, heart function, and costs in 951 patients who were randomly assigned to undergo angioplasty with stenting or to receive medical therapy alone 3 to 28 days after they had had a heart attack. All of the subjects were in stable condition at the time of treatment.

Stenting was associated with a slight improvement in heart function at 4 months. By 1 and 2 years, however, no difference in this outcome was seen between the study groups.

Both treatments also had a similar impact on psychological well-being.

Analysis of data from the 469 patients treated in the US showed that the cumulative 2-year cost in the angioplasty group was $7000 higher than in the medical therapy group.

"What we have here is one of those cases where less is more," Mark said. Angioplasty and stenting to open "blocked arteries more than a day after a heart attack is not a good value."

SOURCE: The New England Journal of Medicine, February 19, 2009.

• More News on Angioplasty
• More News on Heart Attack

Related MedlinePlus Pages:

• Angioplasty
• Heart Attack