Doctors and patients are thinking twice about stenting, which is done together with artery-inflating balloon angioplasty.
"We've definitely seen a decline," said William O'Neill, a prominent cardiologist at the University of Miami medical school. The Courage study "is causing some people to think that angioplasty is unnecessary," he said. "A lot more patients are going to be treated with medical therapy," meaning drugs instead of surgery, he said.
In late March, doctors at a cardiology conference in New Orleans presented a study, known as Courage, showing that heart drugs reduced chest pain almost as well by themselves as when combined with stents. Additionally, stents didn't prevent heart attacks or deaths.
The number of coronary stents implanted in the U.S. dropped sharply in April, according to a leading market researcher, in what doctors said was an unusually quick response to the Courage study showing the devices provided little advantage over drug therapy in some patients.
The new figures are the latest evidence that the tiny scaffolds used to prop open arteries are no longer a powerful growth engine for the medical industry. Americans spent at least $14 billion on coronary-stent procedures last year, including surgical and hospital fees. Worldwide sales of the devices totaled about $6 billion.
Source: The Wall Street Journal, May 17, 2007