When Does a Heart Blockage Need a Stent?

 When Does a Heart Blockage Need a Stent?

Introduction

                                            Image from The Keyhole clinic (2021)

Coronary artery disease (CAD) occurs when plaque builds up inside the coronary arteries, reducing blood flow to the heart and causing ischemia. CAD can cause chest pain, shortness of breath, heart attacks, and other serious complications. One treatment for these blockages blockages is percutaneous coronary intervention (PCI), a procedure that opens a closed off artery, often using a stent. However, not every blockage requires a stent. Researchers have been studying whether measuring how much a blockage actually limits blood flow can help doctors make better treatment decisions. A recent long term study examined whether using fractional flow reserve (FFR) to guide PCI improves outcomes for patients with coronary artery disease.

How Was This Study Done?

The researchers analyzed long term results from the FAME 2 clinical trial. Participants had stable CAD and coronary artery blockages that were evaluated using FFR. FFR is a measurement that determines whether a blockage significantly restricts blood flow to the heart. Patients with an FFR of 0.80 or lower were randomly assigned to receive either FFR guided PCI plus medical therapy or medical therapy alone. The researchers then followed these patients for more than 10 years and compared outcomes between the two groups. They specifically looked at major cardiovascular events, including death, heart attack, and the need for a second procedure on the same artery if a reblockage had occurred (Collet et al., 2026).

What Did They Find?

The researchers found that patients who received FFR-guided PCI had better overall outcomes than patients who received medical therapy alone. After a median follow up of approximately 11.2 years, the primary combined outcome occurred in 33.6% of patients who received PCI compared with 41.3% of those who received medical therapy alone (Collet et al., 2026). However, the difference was largely related to fewer urgent procedures in the PCI group. The researchers did not find a statistically significant reduction in death from any cause.

These results are interesting because they show that opening a blockage can reduce the likelihood of needing an urgent procedure later, but it does not necessarily mean that patients will live longer. I find the study convincing because the researchers used a randomized trial design and followed participants for more than a decade. However, the results should not be interpreted as meaning that every patient with CAD should receive a stent.

Putting It All in Context

This study demonstrates the importance of looking beyond the appearance of a blockage when treating CAD. A coronary artery may appear significantly narrowed on an imaging test, but that does not always mean that the blockage is restricting blood flow enough to require an intervention. FFR provides doctors with additional information about the blockage's actual effect on circulation.

The findings also support previous research showing that FFR-guided PCI can reduce urgent revascularization and improve symptoms in patients with stable CAD (De Bruyne et al., 2012). Fearon et al also revealed that PCI treatment initially cost more, however, the cost became similar after three years to those that received FFR guided PCI due to the increased risk of secondary procedures. This suggest that using FFR guided PCU can improve patient outcomes and be just as cost effective as placing a stent without FFR (Fearon et al., 2018).

Mean cumulative medical costs at the initial hospitalization and at 1, 2, and 3 years, along with mean annual follow up costs for patients receiving percutaneous coronary intervention (PCI) + medical therapy (MT) compared with medical therapy alone. Reprinted from Fearon et al. (2018).

Overall, this research supports a more individualized approach to CAD treatment. Instead of automatically treating every visible blockage, physicians can consider blood flow measurements, symptoms, and other patient factors when deciding whether PCI is appropriate. This approach may help patients receive treatments that provide meaningful benefits while avoiding unnecessary invasive procedures.

References

Collet, C., et al. (2026). Fractional flow reserve-guided percutaneous coronary intervention versus medical therapy for stable coronary artery disease: Long-term results of the FAME 2 trial. Nature Medicine, 32, 318–324. https://doi.org/10.1038/s41591-025-04132-5

De Bruyne, B., et al. (2012). Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. New England Journal of Medicine, 367(11), 991–1001. https://doi.org/10.1038/s41591-025-04132-5

Fearon, W. F., et al. (2018). Clinical outcomes and cost-effectiveness of fractional flow reserve-guided PCI in patients with stable coronary artery disease. Circulation, 137(5), 480–487. https://doi.org/10.1161/CIRCULATIONAHA.117.031907

The Keyhole Heart Clinic. (2021, April 15). Coronary artery disease: treatment, causes & prevention. https://www.thekeyholeheartclinic.com/blog/coronary-artery-disease-causes-treatments-and-prevention-methods/

Bryn Bohannan and Youssef Bakr- 8 famous artists who hid self-portraits in their paintings

https://www.amazon.com/Billy-Goat-Plush-Stuffed-Animal/dp/B00COONE26

Learning With: ‘U.S.-China Trade Standoff May Be Initial Skirmish in Broader Economic War’- Hannah Rodriguez

Because of President Trump's constant taunts and threats toward China, tariffs increase $60 billion worth of American goods. President Trump claims that he will meet with China's President to discuss the intensified trade dispute.

https://www.nytimes.com/2019/05/15/learning/learning-with-us-china-trade-standoff-may-be-initial-skirmish-in-broader-economic-war.html

Harriet Tubman on the 20$ Bill?

Jacob McMakin     https://www.google.com/amp/s/www.cnbc.com/amp/2019/05/22/harriet-tubman-20-bill-no-longer-coming-in-2020.html

     Got any cash, take a look, kind of looks all the same, doesn’t it?  That’s because only a select gender and ethnicity is represented on the currency of a country who calls its self a “melting pot”. In 2016 it was proposed that the 20$ should be replaced with a more fitting and deserving figure, other than the alcoholic, Andrew Jackson.  Tubman seemed fitting, and after thousands of requests by people in power and the public, it was decided that she would be represented.  The original printing date was supposed to coincide with the 100 year anniversary of the passing of the 19th amendment, giving women the right to vote.  Just recently it has been announced by Treasury Secretary, Steve Mnuchin, that the date has been pushed back 8 years due to lack of enthusiasm by President Trump.  Trump quotes on this matter calling it “pure political correctness”, of corse to be taken not by women and people of color as anything to do with “political correctness, but yet equal representation.  Throughout American history women, especially of color, have been pushed quite literally to the back.  Even after the civil rights movement of the 50’s and 60’s, rights have been granted, but equality has not.

What Students Are Saying About: Online Learning, Family Vacations, and Moving To A New Home- Hannah Rodriguez

An online education program in Silicon valley shared there favorite family vacations and gave an idea of what it was like to move into a new home. Because of this writers are going to read writing prompts, something that the writers have told the teens to do.
 Writers are interested not in what the teenagers pick to read, but more about what made what they read so interesting.

https://www.nytimes.com/2019/05/02/learning/what-students-are-saying-about-online-learning-family-vacations-and-moving-to-a-new-home.html?searchResultPosition=1

SISTER JAMES CANCELLED??

kristen ramirez

If you haven't heard, Youtube Makeup Guru James Charles has been cancelled and has lost 3 million subscribers. Why?? Well, Ex best friend Tati exposed James in a recent video titled "Goodbye Sister' by revealing some of his dirty secrets due to him partnering with Sugar bear. Sugar bear is Halo's ( Tati's brand) biggest competitor, In the video, Tati mentions the way James has forced himself towards straight men, him being manipulative, immature and not knowing how to "grow up."

This may be a late blog post about this topic because at this point everyone knows the Tati drama. After the first video posted by Tati, James than released an apology video. It doesn't stop there, Tati posted another video shortly titled "Why I did it" basically stating her reasons for the first video. Following, James released a video titled " The Truth" were he mentions the actual "truth" due to Tati lying and showing receipts. In the video, he mentions beauty guru Jeffery Star who then makes a video clearing some things and apologizing due to some things he said online. The whole situation is very confusing and has been dropped. James, Tati and Jeffery are all ready to let it go and start creating some content. ( Tati since than has deleted the first video)

https://www.youtube.com/watch?v=2rLcu292K_g
https://www.youtube.com/watch?v=uFvtCUzfyL4

Should Congress Try To Impeach President Trump?- Hannah Rodriguez

During the 2016 election of President Donald Trump, there was an investigation of his interference with Russia. Due to further investigation Democratic officials want impeach President Trump. Impeachment is calling into question the integrity or validity of something. For example, impeachment is the process by in which a legislative body charges a government official. This does not result in removal of office, but charges to an indictment in criminal law. 


https://www.nytimes.com/2019/04/25/learning/should-congress-try-to-impeach-president-trump.html

Supreme Court's Decision on Census Could Altger American Politics- Hannah Rodriguez

The United States Census is a head count taken every ten years of all the people living in the United States. The data from the census determine many federal and state decisions, but one of the most important is how many seats in congress will be assigned to the states. Arguments about the next census ask if they will be mainly American citizens. Would having non-citizens of the united states being counted be a problem for the country?
https://www.nytimes.com/2019/04/23/us/noncitizens-census-political-maps.html

Adversity in College Applications

     Jacob McMakin.      https://www.insidehighered.com/admissions/article/2019/05/20/college-board-will-add-adversity-score-everyone-taking-sat

        Everyone faces different struggles in life, and how a child has grown up can drastically change the way they learn.  A new SAT Adversity index has already been used in 50 colleges around the country, and by 2020, SAT is hoping for a full sweep of America.  The index will take into account the wealth, crime rate, and other socioeconomic factors of the child’s high school.  More personal factors will also be taken into account, such as 1/2 parent household, death of a guardian, traumatic events, median family income, and other factors.  The score will be determined out of 100 with a formula, and taken into account for the SAT score.
     Advocates hope this will replace the already used Affirmative Action standards which has been criticized for using “racial quotas” in school.  Some say it will give collages a broader sense of a child’s potential, and help not affect the already affluent children apart of the American Bourgeois.    This has already helped expose the overwhelming amount of black and latinx student who score significantly higher on the index than those of Anglo decent.  Due to years of systematic oppression, even after desegregation.  De Facto segregation still is in place today, with many smart kids not able to receive the equal opportunities as others of different economic, or domestic backgrounds.  

Sex Education- Hannah Rodriguez

Sex Education has been being taught in schools for decades. Sex Education is the instruction of issues relating to sexuality, including emotionally and physically, It is to have knowledge of the responsibilities, the sexual anatomy, sexual reproduction, sexual intercourse, etc. In a Colorado public school, a student stated that his teachers example of sex was repeatedly rolling tape until it lost its stickiness. The student shared the lesson he had been taught by saying,“People are like tape and once they have sex they’re dirty and can’t have meaningful relationships." Because of this Colorado passed a Sex Education Bill. 

The bill updates a 2013 comprehensive sex education law in three significant ways:

• It adds a requirement that Colorado public schools teach kids about consent.
• It removes a waiver for charter schools to opt of the state’s sex ed requirements.
• It funds a grant program for schools that want to teach sex ed but lack the resources to 

The bill got its first hearing in the House Health and Insurance Committee on Jan. 0 and by Feb. 29 it was on its way to senate.

https://www.nytimes.com/2019/04/11/learning/what-has-your-sex-education-been-like.html?register=email&auth=register-email

The Chick-Fil-A bill -Paola Aceves

A new bill in texas is being proposed called, known by supporters as the “Save Chick-Fil-A Bill”. The bill itself is said to support religious freedom, but LGBTQ advocates believe it could be used for anti LGBT actions. The bill was proposed as a response to San Antonio’s city council banning Chick-Fil-A from their airport due to the history of supporting anti-LGBT organizations. The bill is aiming to block government entities from taking action against individuals or businesses based on their religious affiliation.

While this does sound good in theory, it could also harm the LGBT community because of religious views on homosexuality. The LGBT community has been fighting for rights for a very long time and should not get those rights taken away.

Baltimore held hostage- Sophie Knox

https://roguerocket.com/2019/05/22/baltimore-held-hostage-in-ransomware-attack/

Summary: All throughout Baltimore, government servers have been used for hostage for over two weeks. Hackers breached about 10,000 government computers in exchange for 13 bitcoins ($100,000). They even threatened to hack more data if the city didn’t pay. The deadline has passed and Baltimore still hasn’t paid. Fortunately Emergency services like 911 hasn’t been impacted. The hackers used a ransomware called RobbinHood  which blocks access to servers. There is a digital key to unlock it and if they get their money, they will give Baltimore the Key.

Analysis: Our world has become really crazy. I believe in the future as we become more digital, problems like this will become more problem. On the brighter side of things, it’s not as deadly as a real hostage situation, but it is still very bad. Thankfully 911 still works cause otherwise the city would be a disaster. The purpose of this article was solely to bring attention to this massive issue and the audience was to the general public. I can relate this to WW2. After Hitler broke his promise, the allies began to say “No negotiating with terrorists” and like that quote, Baltimore isn’t negotiating with them.

Bleach promoted as Miracle drug- Sophie Knox

https://roguerocket.com/2019/05/22/bleach-promoted-as-miracle-treatment-for-diseases-on-youtube/

Summary: Over the past few years Jim Humble has promotes Chlorine dioxide (also known a bleach) as a miracle drug that can treat almost every disease including cancer, hiv, and autism. He was a former scientist until he formed his own church that promoted alternative medicine. Humble calls it a “Miracle Mineral Solution” and claims he stumbled upon it in South America in 1996. He claims it is a oxidizer and kills pathogens/poison; however the FDA says that the chlorine can’t treat these diseases. To help spread his message, He posted on Facebook and YouTube. Various parent tried this method and witnessed harmful side affects. Many experts believe that this is actually lethal.

Analysis: It is crazy to see what people are willing to try. Firstly, He was a scientist and he should know better than promoting a harmful substance. Although it’s freedom of religion, he’s hurting people through his beliefs. The audience for this article was pretty much everyone I order to help raise awareness to this awful “miracle drug”. The point of view of this article is someone who is ant-chlorine doxide. I can synthesize this to U. S history, because doctors used to think that if a person was sick, they had bad blood and to get rid of that bad blood you needed to bleed. Both this story and that story show incorrect science.

Teacher yearbook photos spark controversy- Paige Bowman

At San Pasqual High School in Escondido California, multiple teachers sparked national controversy after posing in mustaches and sombreros to depict Spanish speaking people. While some parents took it to the offense, some were indifferent. The teachers released a statement apologizing and saying that they welcome all types of students and they will think more carefully in the future.

Arizona prisons ban book about the criminal justice system and black men- Paige Bowman

In Arizona prisons, a certain book isn't very welcome. "Chokehold: Policing Black Men" was written by Georgetown law professor and federal prosecutor Paul Butler. It talks about the connection between the justice system and black men. The Arizona Department of Corrections banned the book, and although it is allowed to prevent incarcerated people to read any book of their choosing, many are calling it unconstitutional. It's being considered that way because it's against the First Amendment to censor a book that would help incarcerated inmates understand how legal, penal, and other institutions shape their lives. Arizona is being called to put the book back on the shelves, as well as other books they've banned other the years.

Iran Update- Clay Seifert

In its strive to cajole Iran into cooperation/elimination/submission, the Trump administration has in the last several weeks applied a TON of force. We blocked the country’s last avenues for selling oil, classified the elite Islamic Revolutionary Guards Corps as a terrorist organization and deployed ships and bombers to the Persian Gulf. However, despite all the new pressure, we’ve recently had no victories or effect on the current state of things. It has only turned Iran’s current state regarding possible negotiations from patience to confrontation. An P. Trump isn’t helping the matter at all, tweeting out attacks on Iran, eventually provoking a response from Foreign Minister Mohammad Javad Zarif, who shot back, “Try respect. It works.”

Also, doesn’t this remind you of some events going on in the early 70s? Crazy.

Nancy Pelosi and Impeachment Talks: a regular day @ the white house - Clay Seifert

Nancy Pelosi went to the White House on Wednesday knowing full well that a planned presidential ambush awaited. Prez Trump was not “serious,” and needed a way out of negotiations over a $2 trillion infrastructure plan that he could not pay for. However, P. Trump’s going off in the white house garden earlier led to a played down topic: impeachment. The only thing proven by Trump’s outburst is that he is willing to sacrifice his legit policy-based agenda to keep “presidential harrassement” in the spotlight. However, talk of a legitimate impeachment is VERY real, as Pelosi stated “We do believe that it’s important to follow the facts. We believe that no one is above the law, including the president of the United States, and we believe that the president of the United States is engaged in a cover-up.” The cover-up quip is what caused P. Trump to explode.

Honest President Trump - Clay Seifert

President Trump abruptly blew up a meeting with Democratic congressinal leaders on Wednesday, dramatically stating that he could NOT work with them until they stopped investigating him and then lashed out at Nancy Pelosi for accusing him of a cover-up. He then marched out into the Rose Garden, where reporters had been just chilling, and stated (clearly shaking (metaphorically) with anger) as he demanded that Democrats “get these phony investigations over with.” This outburst happened on a day where democrats were talking about a possible impeachment, and all of them pressed Pelosi into (possibly(?)) opening a formal inquiry regarding whether Prez Trump should be removed from office or not. He also said that he was “the most transparent president in the history of the United States.” I started cackling when I watched him say that.

Scott's Tots 2.0?? - Clay Seifert

Last week, a billionaire pledged to pay for all the tuitions of students at Moorehouse University. The grant was completely unexpected and kind of out of the blue, as the campus president did not even knowit was coming. However, this issue poses numerous numbers of issues and prompts a ton of logistical difficulties. How will the grants work? What students will be eligible? And students who had to leave due to fiscal difficulties will NOT have their debts paid for, prompting some guilty feelings for some graduates.

Honestly, I just thought this reminded me of Scott’s Tots. We shall soon see whether he pulls a Michael Scott or whether this dream will become a reality.

Trump Tax Returns to be Released. (Probably) - Clay Seifert

New York lawmakers gave their final approval to a bill that would make it extremely possible for Congress to obtain President Trump’s state tax returns, creating another element in the general kerfuffle regarding the president’s refusal to release his taxes. The bill taht will go into place will (tentatively probably) be signed by Gov. Andrew Cuomo, a third-term Democrat and regular cynicist of Prez Trump’s behavior and policies. It will authorize state tax officials to release the president’s state returns to any one of the three congressional committees. Prez Trump said that he is willing to take the fight over his federal tax returns to the Supreme Court, and it seems likely that he actually would honestly based on the current/past state of things and the tensions regarding this.