Hello Doc,

As you must be knowing, Heart attack also called as Myocardial infarction is due to a coronary thrombus or a blood clot in lay man terms which does originate in few minutes obstructs the blood supply in any coronary artery to the myocardium. This whole scene can stretch for about 6 to 10 hours where the myocardium cries out for blood supply creating Angina. If the blood supply reaches the Myocardium in time, the cardiac muscle is saved, if not, the heart muscle is damaged leading to reduction in EF.

The risk factors involved in coronary thrombus initiation include smoking, diabetes mellitus, hypertension, hyperlipidemia, stress, and family history of atherosclerosis. A fissure in the atherosclerotic patch can lead to bleeding and thus form a thrombus.

As you know CABG and PTCA are revascularization therapies for Atherosclerosis and dont reduce even a single percent chance of future MI. Click this link to understand more from Harvard university What can Angioplasty do for you?

If you want to understand about What are the chances of Heart attack after Angioplasty…. Read COURAGE trial where 2 groups of 1000 patients each, were compared with each other. One group underwent only medical management and other underwent Angioplasty. At the end of 4.6 years, death rate due to MI was 18.5% in medical group and 19% in Angioplasty group.

Is Angioplasty better than Medical therapy? Click this link for COURAGE trial.

I hope this answers your question.