Former President George W. Bush's decision to have a stent implanted in an artery yesterday when not in the throes of a heart attack makes him a "poster child" for misuse of the sometimes life-saving technology, according to the author of a study that found the risk outweighs the benefits in those cases.
"He is the poster child for the inappropriate use of stenting now," said Dr. David L. Brown, professor of cardiology at the Stony Brook University School of Medicine and an author of a watershed 2012 study that indicated drugs can reduce heart attack risk as effectively as inserting the expanding metal mesh device without risks including heart attack or stroke.
A blockage in Bush's heart artery was discovered during the former president's annual physical. "At the recommendation of his doctors, President Bush agreed to have a stent placed to open the blockage. The procedure was performed successfully this morning, without complication, at Texas Health Presbyterian Hospital," a spokesman said yesterday.
Industry analyst Josh T. Jennings of Cowen & Co. LLC, said three stent makers, including Natick-based Boston Scientific, compete in the U.S., though sales and prices are declining because of increased medication use.
There can be reasons why patients might choose a stent without having had a heart attack, said Dr. John Keaney, chief of cardiovascular medicine at the University of Massachusetts Medical School.
For athletes, the side-effects of heart drugs, particularly beta blockers, can be debilitating, said Keaney, who is not involved in Bush's medical care. Bush is known as a strenuous exercise enthusiast who runs and rides mountain bikes regularly.
"He may not want to take a lot of medications because he does not want the side-effects they bring, which could leave him too weak to continue his activities," Keaney said.
Despite declining sales, stents have been one of the fastest-developing devices in medicine, said Massachusetts General Hospital interventional cardiologist Robert Yeh, who said the future for innovation remains promising. "On the horizon, being tested now are bio-absorbable stents which the body absorbs without leaving any metal."
Jennings said he's not sure if advances will bump up the manufacturers' bottom lines.
"There are fewer stents per case and fewer patients needing angioplasty," Jennings said.
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