If you suffer a mild heart attack, your chances of survival are better if the hospital does not immediately operate but instead adopts conservative management of the condition.

Patients who are given a bypass or balloon angioplasty are more likely to die, new research has found.

The difference between the two groups was significant. Overall, 80 of 138 people given invasive treatment died during a 23 month follow up, compared with 59 who died from a group of 123 patients who had conservative management, which included testing and medical treatment such as drugs therapy.

The findings have particular significance in the US, where aggressive intervention is now standard treatment despite the fact that the latest study is but one of four major trials to show that conservative management is usually preferable.

One possible reason is due to the high numbers of cardiologists trained in invasive techniques. The number of balloon angioplasty procedures rose 6000 per cent in the US between 1980 and 1992 (New England Journal of Medicine, 1998; 338: 1785-92).

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Written by What Doctors Don't Tell You

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