Developments in Brief : Doubts Raised About Effect of Angioplasty

A noted cardiologist says a new study of heart attack patients may let some air out of the “high-flying balloon of angioplasty,” the fast-growing method of opening closed coronary arteries with a tiny balloon catheter.

The non-surgical treatment, which is becoming a major alternative to coronary artery surgery, has grown from about 32,000 procedures in 1983 to a projected 160,000 in 1987.

But, in an unexpected finding, researchers reported that the new therapy did not improve survival in almost 100 heart attack patients who had first failed to respond to a new clot-busting drug. The death rate of that group, members of which had their clogged coronary arteries forced open with balloon angioplasty, was 10.4%, the same as that of conventionally treated patients--patients who received neither angioplasty nor the new drug called tissue plasminogen activator, known by its initials, TPA.

Dr. Thomas J. Ryan, former president of the American Heart Assn. and chief of cardiology at Boston University medical school, said the outcome was “startling and disturbing.” In an editorial accompanying the study in the current New England Journal of Medicine, Ryan said the trial may be the “first indication that as a treatment for acute myocardial infarction (heart attack), the high-flying balloon of angioplasty has lost some of its air.”