- News Home
5 December 2013 11:26 am ,
Vol. 342 ,
Thousands of scientists in the Russian Academy of Sciences (RAS) are about to lose their jobs as a result of the...
Dyslexia, a learning disability that hinders reading, hasn't been associated with deficits in vision, hearing, or...
Exotic, elusive, and dangerous, snakes have fascinated humankind for millennia. They can be hard to find, yet their...
Researchers have sequenced and analyzed the first two snake genomes, which represent two evolutionary extremes. The...
Snake venoms are remarkably complex mixtures that can stun or kill prey within minutes. But more and more researchers...
At age 30, Dutch biologist Freek Vonk has built up a respectable career as a snake scientist. But in his home country,...
Since arriving on the island of Guam in the 1940s, the brown tree snake ( Boiga irregularis ) has extirpated native...
An animal rights group known as the Nonhuman Rights Project filed lawsuits in three New York courts this week in an...
- 5 December 2013 11:26 am , Vol. 342 , #6163
- About Us
Bypassing the Bypass
17 June 1998 7:00 pm
Heart attack victims, their families, and their doctors often turn to drastic techniques and the latest in high-tech equipment to prolong life. But male patients are less likely to have a second heart attack or die--at least in the short term--if they forgo invasive therapies, according to provocative findings in tomorrow's New England Journal of Medicine.
Researchers at 15 Veterans Affairs medical centers wanted to evaluate different kinds of treatment for a common kind of heart attack, called a non-Q-wave myocardial infarction. This condition gets its name from the lack of a wave drawn by an electrocardiogram, or EKG, a device that charts changes in the electrical activity of the heart as it beats. The researchers randomly divided 920 patients into two groups, for invasive or conservative treatments, and followed their health for an average of 23 months.
Of those in the invasive group, 96% underwent routine coronary angiography--invasive radiography that visualizes the arteries--and 44% underwent popular "revascularization" procedures such as bypass surgery, angioplasty, or both. Patients in the conservative group only resorted to such invasive tests and therapies after physicians spotted signs of potentially life-threatening complications such as ischemia, or oxygen-starved tissue. As a result, conservatively treated subjects had only half as many of the invasive angiography procedures, and only 33% underwent revascularization. Although the survival rates for patients in both groups were about the same for those who made it through the first year after leaving the hospital, the story was quite different among patients who died quickly: The invasive group suffered two to three times as many heart attacks or deaths in the month following discharge.
This and similar studies show "with remarkable clarity and consistency" the benefits of a conservative approach to therapy, write Richard Lange and L. David Hillis of the University of Texas Southwestern Medical Center at Dallas in an accompanying editorial. When treating uncomplicated cases, physicians should not be swayed by financial incentives or a desire to use all the available technology, they say.