Angioplasty is often appropriate following a heart attack. It is the most effective way to treat people with ST-elevation heart attacks. To be effective, angioplasty must be done early -- ideally within 90 minutes of the start of symptoms, but certainly within 24 hours.
But the decision to use angioplasty to alleviate angina and other heart problems should be made on an individual basis. Angioplasty can treat narrowing at curves in coronary arteries, disease in several vessels, and even narrowing in coronary artery bypass grafts. Because of technical advances in angioplasty, doctors are now willing to perform it on some people for whom it used to be considered too risky.
Angioplasty does not solve the underlying problem of atherosclerosis. The procedure may open one or more narrowed arteries, but it is likely that atherosclerotic plaques lurk elsewhere. Even after people undergo angioplasty, they still have to take other steps to reduce their risk for heart attack, such as eating better, getting more exercise, and taking medications as prescribed.
And if you have stable angina (or no symptoms at all) from a narrowed coronary artery, medical therapy alone is a better option than more aggressive treatment, according to the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, which was published in 2007. Contrary to what many people believe, angioplasty done for mild or no symptoms does not protect you from having a heart attack in the future.
However, if you are having a heart attack or an episode of unstable angina, angioplasty is definitely better than drug treatment at preventing a second heart attack and improving survival.
Angioplasty is often appropriate following a heart attack. It is
the most effective way to treat people with ST-elevation heart
attacks. To be effective, angioplasty must be done early -- ideally
within 90 minutes of the start of symptoms, but... More