With about 800,000 acute heart attacks occurring in the U.S. every year, and heart disease being the number one killer, you would think that a new clinical trial showing benefits from opening up all significantly blocked heart blood vessels in addition to the blocked artery responsible for the acute attack would merit big headlines.
Think again. You would be wrong.
Not only were there no big headlines, there was no coverage at all.
Instead of headlines, all major U.S. mainstream media left a complete news blackout of the COMPLETE clinical trial. That's right, completely ZERO coverage. Just like it never happened.
"Complete" refers to complete revascularization of all the other significantly blocked coronary vessels in addition to the main culprit lesion responsible for the heart attack, which in this study was limited to ST-segment elevation myocardial infarction (STEMI). About 50% of STEMI patients have more than one blocked artery in addition to the culprit acute blockage.
Here's how MedPage Today covered the trial and its simultaneous publication in the New England Journal of Medicine.
But missing in action were the New York Times, the Wall Street Journal, the Washington Post, the Los Angeles Times, USA Today, CNN, and all major network and cable TV news networks.
I never expect much from the TV networks, because their producers get all their news from the print media.
That in spite of the study being published immediately online by what the media used to refer to as the "prestigious" New England Journal of Medicine.
Don't take my word for it. If you have access to the Lexis Advance database that tracks over 11,000 news sources, do the search. See who covered the COMPLETE trial, which was presented at the just-completed European Society of Cardiology meeting in Paris (France, not Texas) and immediately posted online in the NEJM, along with an editorial.
You'll find sparse reports, mainly from Canadian newspapers. The lead author, Shamir Mehta, MD, is an interventional cardiologist and a professor at McMaster University and Hamilton Health Sciences in Hamilton, Ontario. But the study involved over 4,000 patients randomized in 140 centers in 31 countries, including U.S. medical centers like Duke and Mt. Sinai. Over 1,500 of the patients enrolled were Canadians.
Toronto's The Globe and Mail ran the story of the study results on page A1, with the headline: "New study led by McMaster University expected to change the way doctors treat heart attack survivors."
There were stories on the study in Thailand, India, and even Iran.
A call to the American College of Cardiology's director of media relations, Nicole Napoli, produced speculation that the non-coverage by U.S. mainstream media was due to lack of media present in Paris at a "European meeting."
The Times did cover one study from the ESC meeting: a study showing weight loss surgery appeared to have a dramatic effect on reducing cardiovascular events and premature death in type 2 diabetics. It was published on Sept. 2, the day after the COMPLETE trial was published in the Canadian papers and this publication featured it.
And most surprising, the bariatric surgery study was observational, not even a randomized controlled trial (RCT).
My speculation for the reason for the lack of media coverage is the "less is more" mentality and biases of major U.S. medical politicians that there are too many "unnecessary" procedures like cardiac caths for pre-op evaluations and PCIs for stable coronary artery disease. The spillover effect of that mentality affects the treatment of acute MIs. And the mainstream media have lapped it up deciding that complete revascularization is just another example of a flawed RCT that should be suppressed or at least explained away. To this crowd, the ORBITA trial, sham stenting for stable coronary artery disease, is the best clinical trial that ever happened in the history of cardiovascular medicine.
Brant S. Mittler, MD, JD, has been a cardiologist in private practice in San Antonio for the past four decades and has a litigation practice in healthcare law.