Former US president’s procedure “another example of the inappropriate stenting trend in the USA”


Former US president George W Bush’s recent heart stent operation will further increase the popularity of what is often an unnecessary and wasteful procedure, says an analyst with research and consulting firm GlobalData.

Bush received a stent for coronary artery disease following a regularly scheduled visit to his doctor. No symptoms of cardiac distress were exhibited.

“This raises questions as to why he underwent this expensive intervention, which has been shown to be ineffective in patients who are asymptomatic, and serves as another example of the inappropriate stenting trend in the USA,” said Joseph Gregory, GlobalData’s analyst covering Surgical Devices.

A study published last year found that patients with asymptomatic coronary artery disease did not benefit any more from stenting procedures than those who were treated solely with medication, in terms of death, non-fatal heart attacks, unplanned revascularisation, or angina. However, despite being proven of questionable value, Gregory believes this recent high-profile incident will lead to a short-term increase in stenting procedures.

He said: “This story was covered by every major news network in the country, so it is not too farfetched to say that nearly every American is aware of the former president’s procedure.

“This means that the non-medically savvy population is going to assume it is the most optimal treatment and therefore request it—should they find themselves with similar coronary conditions. Thus, the media coverage of Bush’s procedure will further contribute to the inappropriate stenting trend that persists in the American healthcare system.”

The most recent study to examine the application of stents in the USA (Paul Chan and colleagues, Journal of the American Medical Association, 2011) found that in a non-acute setting, only 50% of the procedures were classified as appropriate.