To stent or not - that is the question

[brendan856]

I have had one stent (non-medicated) after a minor heart incident 7 years ago.  A recent stress stest showed some new abnormality.  I really do not have many if any symptoms - other than some occasional pain (very infrequent) and occasional cold hands.

My doctor is recommending the cardiac cath - but he indicates that the statistics don't increase that greatly with having a cath and possible stent insertion.

The question is to have a cardiac cath or not?  Or is medication sufficient?  Blood pressure and cholesterol are both very low.  Diet is good - main problem area is smoking 1/2 pack per day.

Also - what about medicated vs. non-medicated stents?

Thank you for your comments.

[kenkeith]

Some interventional cardiologists have gone back to bare metal stents.  DES may have a better record for no restenosis, but there is a higher risk for blood clots for the first year or more.

Statistics and my source is the COURAGE study conclude meds, stents or bypass do not increase life span but only treat the symptoms.  A bypass is appropriate in an emergency (life or death).  If medication does not control symptoms (angina), then a stent may be appropriate.

I have been on medication for CAD for more than 5 years,  Involved is a 100% occluded LAD and 72% circumflex...98% RCA has been stented with DES 5 years ago.  I am asymptomatic.  To answer your question, if medication controls (dilates vessels) symptoms there is no rational reason to have a stent implant.