Angioplasty In The 30s Is Becoming Common: Is It Worth the Risk?

Heart disease is one of the main causes of all fatalities across the world today. Once associated with older adults, the incidence of heart disease has also witnessed a rise among younger adults in their 30s. This should not be surprising, considering that our modern lifestyle greatly increases the risk of cardiac disease, cancer, and diabetes. The outcome for heart patients has greatly improved over the years however, as modern medicine has made significant advances and there are numerous treatment options available today.heart-angioplasty

Heart Disease In 30 Year Olds

“While genes are a contributing factor for coronary heart disease, smoking is one of the biggest risk factors along with high homocysteine and cholesterol levels, and a sedentary lifestyle”

Current trends show an alarming rise in the incidence of coronary artery disease and heart attacks among young Indians in their 20s and 30s, with many needing angioplasty at a very early age. While genes are a contributing factor, smoking is one of the biggest risk factors along with high homocysteine and cholesterol levels, and a sedentary lifestyle. These factors contribute to a narrowing of coronary arteries and thickening of platelets in the blood. Angioplasty and stents are the most common recommendations for treatment of blockage resulting from coronary artery disease, but to understand the efficacy of stents and angioplasty for 30 year olds, you need to be more aware of its purpose and how it works.

How Angioplasty Works

“The inflation of the balloon in the artery helps open it up, restoring blood flow to the heart, while insertion of stents prevents closing of the artery”

An angioplasty procedure involves the insertion of a catheter into the patient’s blocked coronary artery and the inflation of a tiny balloon once inside the artery.The inflation of the balloon helps open the artery, restoring blood flow to the heart. A stent is a tiny, hollow, cylindrical device made of stainless steel that is directed to the site of the coronary artery blockage, the same way a balloon is, and is left inside the artery to prevent it from closing again. Doctors usually recommend the angioplasty procedure when plaque buildup in the coronary artery begins to cause symptoms like chest pain, chest pressure, and shortness of breath despite the use of conventional and alternative therapies.

The Risks Of Angioplasty

Angioplasty is considered safe, but there are a number of inherent risks as is the case with many medical procedures. Angioplasty poses the risk of allergic reaction to the drug used in the drug eluting stent, blood clot, heart attack, kidney failure, bleeding or clotting where the catheter was inserted, irregular heartbeat, and stroke.

Do The Risks Outweigh The Benefits Of Angioplasty?

According to the National Investigation Council Registry (NIC), in the year 2004 almost 2.5 lakh angioplasties were performed and this number rose by a whopping 14% by 2014. However, there has also been a 40% rise in the number of deaths during or immediately after angioplasties that were performed in 2014, as compared to in 2013. Here is what research suggests:

According to the American Health Association (AHA) and the American College of Cardiology Foundation (ACCI)-

  • Meta-analysis have failed to show that introduction of Bare Metal Stent (BMS) confers a survival advantage over balloon angioplasty

  • Meta-analysis has failed to establish that the introduction of drug eluting stent (DES) increases survival chances over BMS angioplasty

  • Till date, studies have failed to demonstrate that PCI (angioplasty) in patients with stable ischemic heart disease improves survival rate

  • Evaluation of 13 studies, from 5442 patients, did not show any benefit of PCI over medical therapy for individual endpoints of all causes of death, cardiac death, and heart attack.

According to the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgeons (EACTS)-

  • Courage trial, which included almost 2300 patients,indicated that there was no significant difference between PCI and medical therapy in terms of fatality, heart attack and stroke

  • 1 Meta analysis with updated clinical trials suggested that PCI was not associated with any significant improvement in all cause deaths or repeat angioplasty procedure

  • A study involving 76 clinical trials with 1,17,762 patients did not reveal a lower risk of death

In many cases, the decision to undergo angioplasty procedure is viable, especially if you are symptomatic with a high risk profile and if your quality of life is poor. However, if you are asymptomatic, as is the case with most younger adults, it might be better to get a second or even third opinion as research has revealed. Thus, angioplasty should be used in rare cases and an overwhelming majority of patients can be safely treated with a vigorous collaboration of diet, exercise, yoga and appropriate medication.

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Christus, T. et al. “Coronary Artery Disease in Patients Aged 35 or Less – A Different Beast?” Heart Views : The Official Journal of the Gulf Heart Association 12.1 (2011): 7–11. PMC. Web. 31 Aug. 2016.

Webb JG, Myler RK, Shaw RE, Anwar A, Stertzer SH. Coronary angioplasty in young adults: Initial results and late outcome. J Am Coll Cardiol. 1990;16(7):1569-1574. doi:10.1016/0735-1097(90)90302-6.

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