Contradicting current practice standards, an important new study indicates that opening blocked coronary arteries with angioplasty and stents isn't beneficial when performed 3 days or more after myocardial infarction (MI). Researchers say that patients who are stable and pain-free days or weeks after an MI are better off with noninvasive therapies that reduce cholesterol levels, clotting, and inflammation. However, angioplasty and stent placement may still be the best treatment for patients who get to the hospital within 12 hours of MI onset. (The study didn't examine stent use in patients who haven't had MIs.)

Other research has shown that drug-coated stents may increase the risk of blood clots, even years after implantation. The researchers say their study reinforces this evidence, showing that stents are being overused and may actually contribute to MIs and death.

The study, sponsored in part by the National Heart, Lung, and Blood Institute, involved 2,166 patients at 217 hospitals in the United States and abroad. Results were presented at a meeting of the American Heart Association in November in advance of publication.

SourceHochman JS, et al., Coronary intervention for persistent occlusion after myocardial infarction, The New England Journal of Medicine, December 7, 2006.