A recent study by the University Hospital in Nottingham indicated that bypass surgery was a more successful treatment of angina than angioplasty. A survey of 1,011 patients showed that six times as many angioplasty patients needed repeat treatment or surgery as those who had bypass surgery. The report also found that angina was almost three times as common in angioplasty patients as in bypass patients within six months of the treatment (The Lancet, 6 March 1993).
However, as already indicated, bypass surgery is most appropriate in treating those with triple vessel disease (when two thirds of each artery is blocked). This covers just 10 per cent of all heart condition sufferers. Bypass surgery is, of course, a major and traumatic procedure, and the death rate has ranged from as low as 3 per cent to an alarming 23 per cent in the US.
In the 1970s, several major studies revealed that bypass surgery did not improve survival except among patients with severe coronary disease, particularly to the left ventricle. It did, however, relieve severe angina (New England Journal of Medicine, 2 January 1992).
Even though it is an appropriate treatment for just 10 per cent per cent of sufferers, the bypass seems to be surviving better than its patients. Perhaps this is not surprising when you consider that, in the US, it is one of the best paying surgical procedures, with surgeons earning about $40,000 an operation. Overall, the treatment costs Americans $5bn a year, to treat just 200,000 people.
Another route gaining credence in traditional medicine is thrombolytic therapy, drugs that break up clots. A recent study in Northern Ireland tested two of the drugs Kabikinase and Eminase on 37 patients in a 129 strong patient group. The 37 received early therapy, as soon as the symptoms of heart trouble were diagnosed, while the remainder were given the treatment only on admission to hospital.
Within 14 days, one patient on early treatment had died against 10 in the second group; after one year, two had died in the first group against 17 in the second. At the end of the two year trial, another four had died in the second group.
Clearly, drugs therapy is the least traumatic and least expensive of the routes. But while the Northern Irish study was testing the efficacy of the treatment on diagnosis, it also showed that the mortality rate by using the drugs was nearly 15 per cent, an uncomfortably high figure.
So what should you do if you are diagnosed as at risk from heart disease? Despite the impression given by many doctors, heart surgery is often not urgent. Dr Wayne Perry a proponent of chelation therapy as an alternative to surgery (see below) suggests patients should discuss with their doctor the possibility of deferring a heart operation for a year while they try other, less invasive methods of treatment, such as changes to diet, exercise and stress management programmes, possibly combined with chelation therapy. Only if these other methods don't work should you think about going ahead with surgery.