Any minute now, you can lose your breath. You can feel faint. You can break into a cold sweat. You may have heart disease. But there’s something that could help you.
It all begins with knowing your heart better and what it’s trying to tell you. In 2003, a study made by the Philippine Health Statistics revealed that about 17.1 percent of total deaths among Filipinos were heart disease-related. (That’s heart attacks, among many others.) In 2005, heart disease remained among the country’s 10 causes of morbidity. It ranked seven, in fact, accounting for 52.6 percent per 100,000 of the population. True, heart disease remains at large. But there is now good reason to believe it can be stopped from claiming lives incessantly.
Next to heart attacks, coronary heart disease (CAD) is a common culprit among cardio patients. It is caused by a sudden narrowing down or blockage of the coronary arteries, leaving blood unable to flow through the heart, thereby depriving it of much needed oxygen. More, this narrowing down is usually brought about by fat accumulations or plaque in this part of the heart.
When treating this disease, cardiologists often gauge the severity of a patient’s case before naming any treatment options. For least severe ones, certain medications are prescribed such as nitrates, beta blockers, and calcium channel blockers. For the worst cases, treatment dictates that patients undergo an open heart procedure called coronary artery bypass graft surgery (or simply, bypass). But for those whose case is beyond medication but just the same requiring a less-than-drastic procedure, the percutaneous coronary intervention or PCI is recommended.
The PCI procedure is relatively simple, taking only a few hours under local anesthesia and allowing patients to be discharged within a couple of days. It is a heart remedy that is less intrusive and, to the patient’s relief, less risky. PCI is also known as angioplasty with stent placement, the name itself giving one an idea of what exactly is to be done.
An incision is first made into the patient’s groin or femoral area. And from here, a small catheter sheath is inserted into the artery. With the aid of this, an x-ray dye is then injected into the body, allowing the doctor to examine the blockage and, at the same time, make sure that the catheter is in place. When all is right, a balloon carrying a stent — a graft that will keep the arteries from narrowing down — is then inserted into the body. Once in its proper place, the balloon is inflated, thereby also opening the stent that would keep the arteries open and blockage-free.
After this procedure, the patient is also required to undergo anti-platelet therapy. This is done to avoid stent thrombosis, or the formation of blood clots in the blood vessel. Just like other medical procedures, the patient is expected to come in for a series of follow-up checkups. This is scheduled 30 days after the treatment, then three months, six months, and finally, after a year. Hopefully, after all this, your stent has indeed been a success.
Sometime back, only bare metal stents were offered for the PCI treatment. And 20-40 percent of the time, it caused restenosis, or the narrowing down of the arteries once again. That is why today, drug-eluting stents, which reportedly have a mere five to 10 percent restenosis rate, are much more preferred.
Drug-eluting stents are stents coated with drugs that help in treating a patient’s CAD. Among the two known drugs used here are rapamycin and paclitaxel. Also known as sirolimus, rapamycin is an immunosuppressant drug developed by Wyeth primarily to help prevent organ rejection in liver transplants. On the other hand, paclitaxel is primarily an anti-cancer drug developed by Boston Scientific. Whichever condition these drugs were first perceived to improve, it is clear that their use has expanded since.
Drug-eluting stents are now being manufactured in the United States by Johnson & Johnson as well as Boston Scientific. Here in Asia, a drug-eluting stent called Firebird was launched last year.
Firebird is a rapamycin-eluting stent that has been developed by Otsuka Pharmaceuticals Philippines and Microport in China. Today, this stent has been successfully used in 300 percutaneous coronary intervention cases.
Overall, the coming of drug-eluting stents is welcome news to CAD patients whose cases don’t require a bypass. But it must be stressed that one should consult with one’s cardiologist before undergoing any procedure.
As far as percutaneous coronary intervention is concerned, there are also certain allergy histories to consider. Those allergic to metal, drugs such as rapamycin and paclitaxel as well as anti-platelet therapy drugs are highly discouraged from this treatment.
A percutaneous coronary intervention using one stent costs about P300,000 to P500, 000. This procedure is done in certain cardiac catheterization and intervention laboratories or simply cathlabs, which can now be found in various hospitals throughout the country, including Asian Hospital, Cardinal Santos Medical Center, Chinese General Hospital, Makati Medical Center, Philippine Heart Center, Philippine General Hospital, St. Luke’s Medical Center, University of Santo Tomas Hospital, and The Medical City.
In Cebu, there are also three cathlabs now operating at the Cebu Doctors Hospital, Chong Hua Hospital, and Perpetual Succor Hospital. In Davao, there’s one at the Doctors Hospital.
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For more information, visit the Philippine Society of Cardiovascular Catheterization & Interventions, Inc. at www.pscci.org.ph.