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Andrew Rudin Cardiology | Do You Really Need a Stent?

The Truth About Heart Disease Treatment You Won’t Hear in Every Exam Room

You go in for a routine check-up or stress test. Your doctor finds a blockage. The next thing you know, you're scheduled for a stent.

It feels urgent. It sounds lifesaving. And no one wants to take chances when it comes to the heart.

But what if, in many cases, stents don’t actually prevent heart attacks or save lives—at least not the way we’ve been led to believe?

“We’ve relied on stents as a reflex response to coronary artery disease, but the science now tells us we need to be more thoughtful,” says a spokesperson from Andrew Rudin Cardiology, a patient-focused cardiovascular practice that emphasizes evidence-based care.

In this article, we’ll unpack what stents really do, when they’re necessary, and why some patients may want to pause and think before proceeding.

What Is a Stent?

A coronary stent is a tiny mesh tube inserted into an artery to help keep it open. It’s usually placed during a procedure called angioplasty, where a balloon is inflated inside a blocked artery to restore blood flow.

This procedure is extremely common—and in certain cases, absolutely necessary, particularly during an acute heart attack, where every minute counts.

But here’s the catch: stents are also frequently used in non-emergency cases, such as when patients have stable angina (predictable chest pain) or no symptoms at all. And in these situations, the benefits of stents aren’t as clear as you might think.

What the Research Really Says

A groundbreaking study known as the ISCHEMIA trial, published in 2020, changed the game for cardiology.

Over 5,000 patients with moderate to severe coronary artery disease were followed. Half underwent invasive treatment (stents or bypass surgery), while the other half were managed with optimal medical therapy—medications, diet, exercise, and close monitoring.

The results? After several years, there was no significant difference in the rate of heart attacks or deaths between the two groups.

“This was a wake-up call,” explains a cardiologist affiliated with Andrew Rudin Cardiology. “We’ve learned that for stable patients, starting with non-invasive treatment is not only safe—it’s often just as effective.”

Why Heart Attacks Don’t Always Happen Where You Expect

Many people assume that a major blockage is what causes a heart attack. So it makes sense—fix the blockage, prevent the heart attack. But here’s the surprising truth:

Most heart attacks don’t happen at the site of the biggest blockage. They occur where smaller, unstable plaques rupture unexpectedly, triggering a clot that blocks blood flow.

A stent placed in a “tight” area doesn’t prevent this from happening somewhere else.

That’s why, according to Andrew Rudin Cardiology, the key to preventing heart attacks lies not in one procedure, but in treating the disease systemically—through medications, healthy habits, and long-term risk reduction.

When Is a Stent the Right Choice?

To be clear, stents are not bad—they're just overused.

They remain the gold standard in emergencies, including:

Heart attacks (STEMI/NSTEMI)

Unstable angina, where symptoms worsen quickly

High-risk blockages in critical areas

Persistent, lifestyle-limiting symptoms that don’t improve with medication

But for people with stable coronary artery disease, especially those not experiencing symptoms, it's often best to start with medical therapy first.

“In medicine, more isn’t always better,” says a physician from Andrew Rudin Cardiology. “Sometimes, the best thing we can do is educate the patient and empower them to make an informed decision.”

Risks You Should Know About

While generally safe, stents do come with risks:

Bleeding or complications during the procedure

Blood clots forming inside the stent

Re-narrowing of the artery (restenosis)

Side effects from medications, like long-term blood thinners

False sense of security, leading some to abandon lifestyle changes

The last point is critical. A stent may help symptoms, but it doesn’t cure heart disease—and without addressing the root causes, long-term risk remains.

What Works for Preventing Heart Attacks?

So if stents aren’t always the answer, what is?

The answer lies in comprehensive, preventive care, including:

Cholesterol management (statins or PCSK9 inhibitors)

Blood pressure control

Antiplatelet therapy (like aspirin)

Smoking cessation

Diet changes (such as a Mediterranean-style plan)

Consistent physical activity

Stress management and better sleep

These strategies don’t just relieve symptoms—they address the underlying disease.

At Andrew Rudin Cardiology, the emphasis is on partnership, guiding patients through these changes with education, compassion, and tailored care.

Questions to Ask Before Getting a Stent

If you're facing a decision about a stent and it's not an emergency, take a moment and ask:

Is this urgent, or do I have time to explore my options?

What are the risks and benefits of this procedure?

How might medical therapy compare to a stent in my case?

Am I treating a symptom, or solving a long-term problem?

Do I feel fully informed—or do I want a second opinion?

Your health is yours. You have every right to understand your treatment, explore your options, and choose what feels right for you.

“In cardiology, the best decisions are made not in a rush, but in thoughtful conversation,” says a patient education coordinator from Andrew Rudin Cardiology. “It’s not just about treatment—it’s about trust.”

The Bottom Line: Think Long-Term, Not Quick Fix

Stents are a powerful tool—but they’re not a cure-all. And in stable heart disease, they’re not always necessary.

What truly protects your heart is a long-term strategy: better habits, consistent medication, and a commitment to understanding your own health.

If you’ve been told you need a stent and you’re not having a heart attack, you have time. Time to ask questions, to weigh options, and to make an informed, empowered choice.

🫀 Take Control of Your Heart Health

Before you say yes to a stent, make sure you say yes to the full story.

If you’ve had experience with stents—or chose a different path—share your story below. Your voice might help someone else make a better decision.

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