CARDEONEWS

by Jorge Chavez, M.D. F.A.C.C.

Does a stent prevent heart attacks?

Coronary stents are small, mesh tubes that can be placed in a coronary artery to open a blockage and provide better blood flow to the heart.  The procedure to place these stents is called by several names, including coronary angioplasty and percutaneous coronary intervention (PCI).  In coronary angioplasty, a special catheter containing a small balloon and stent is inserted into a blood vessel in the arm or groin and is advanced through blood vessels and into the heart. When the catheter reaches the blockage in the coronary artery, the physician inflates the balloon on the tip of the catheter, which causes the stent to expand and squeeze the blockage against the walls of the coronary artery. 

This action increases the diameter of the artery and allows for better blood flow.  Once the blockage has been completely squeezed against the walls of the blood vessel, the physician will remove the catheter and balloon.  The stent remains permanently in the coronary artery.

In general, the best way to prevent heart attacks is by taking medications.  Heart attacks (also known as myocardial infarctions) result when a blockage breaks apart, causing the accumulation of clotting factors, a sudden, complete blockage of the coronary artery, and subsequent heart muscle death.  Medications are the best way to prevent this from happening.  For example, cholesterol medications, such as statins, appear to be best in preventing blockages from breaking apart, and aspirin is best at interrupting the accumulation of clotting factors and preventing the development of a heart attack.  Your physician will be able to determine the specific medications that are best for you to prevent heart attacks.

Since coronary stents don’t prevent blockages from breaking apart, they don’t prevent heart attacks.  Rather, by improving blood flow to the heart, they can greatly improve angina, or chest pain, symptoms.  In addition, they also are important in treating heart attacks.  Thus, stents are only indicated for patients who are having angina symptoms or are in the midst of having a heart attack.