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Jonathan Engler's avatar

Interesting thing about this is that because it's a hazard, not a benefit, the additional risk is described in absolute terms ("small additional risk").

Contrast to the way in which pharma products (think statins and mRNA covid injections) always describe their benefit using relative risk reduction.

I am sure that if the major event risk had been reduced from 3% to 1.5% instead of being increased from 3 to 6% the headline would have been "angioplasty halves risk of death or MI" not "angioplasty results in small reduction is risk of death or MI"

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William H Bestermann Jr MD's avatar

I agree this is dark stain on American medicine and it underscores the reason patients don't trust our system. Americans are subjected to these invasive procedures--you can count on that. But you can't count on receiving best practice medical therapy or optimal medical therapy (OMT) which is the most effective treatment for vascular disease. That is tragic, because if you compare OMT vs usual care in the same institution 10 times as many people die of cardiovascular and all causes after 4.5 years. Not 10%. 10 times. And you pay over $20,000 more per year for the privilege of increased risk. The American College of Cardiology now recommends OMT first but most people don't have access. It is past time to fix this. The problem is worse in women because the have heart attacks and die without chronic obstructive coronary disease. They are often told they have no heart disease.

https://pubmed.ncbi.nlm.nih.gov/20973686/

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