Sept. 24 (Bloomberg) -- Artery-opening angioplasty adds $10,125 to a patient's medical bill without significantly extending life or improving health for someone with chest pain, researchers said.

The figure, released today by the American Heart Association, is the latest finding that prompts some doctors to question the value of angioplasty procedures performed on more than 800,000 U.S. patients each year, at a cost of about $10 billion annually. Half of those are done to treat ``stable'' angina -- temporary chest pains that can be treated with drugs, diet changes and exercise, the study said.

The procedure, in which a heart artery is unclogged with a balloon and propped open with a tiny tube called a stent, costs $34,843, including follow-up care. That compares with $24,718 for a regimen of anti-cholesterol medicines and lifestyle changes, researchers reported in the association's journal, Circulation: Cardiovascular Quality and Outcomes.

``Although the difference narrows somewhat over time, it is never made up,'' the researchers said in the study. While angioplasties may make sense for heart attack or severe blockages, ``medical therapy alone offered better outcome at a lower cost'' for those with stable coronary disease.

The results pose a challenge for device makers including Boston Scientific Corp., Abbott Laboratories,Johnson & Johnson and Medtronic Inc., whose revenue from drug-coated stents topped $4 billion in 2007. Sales of the $2,000 tubes have rebounded after falling 30 percent last year amid concerns the products triggered fatal blood clots.

Seven-Year Study

The study, funded by the U.S. and Canadian governments, is the third installment of a seven-year investigation dubbed Courage. Last year, researchers said drugs and lifestyle changes prevented deaths and heart attacks just as well as angioplasty. A report last month found both methods effective at easing chest pains after two years, though angioplasty offered some early advantages.

Most of the increased expense of angioplasty came from the operation itself, which cost $12,162 compared with $752 for the initial drug therapy. After that, follow-up care and medication expenses were about the same.

Angioplasties increased costs by $206,229 per year of extended life, said the researchers, led by William Weintraub, a cardiologist at Christiana Health Care System of Newark, Delaware.

The study has limitations, such as its use of older devices, that make its implications unclear, said cardiologists Ajay Kirtane and David Cohen, in an editorial published with the new data.

Old Stents

Courage tracked patients given bare-metal stents, rather than the drug-coated models now more common. The drug coatings block scar tissue that can reclog arteries and would likely increase the benefit of stenting, wrote Kirtane, of Columbia University Medical Center in New York, and Cohen, of Saint Luke's Mid America Heart Institute in Kansas City.

Courage's medical therapy, relying on low-cost drugs and diligent patient follow-ups, may be hard to match in the real world, Kirtane and Cohen said. During the study, a third of people on the drugs-only therapy eventually needed angioplasty or bypass surgery to unblock an artery.

The discussion may be moot since government and private insurers haven't issued guidelines requiring doctors to weigh the costs and benefits of angioplasties, Kirtane and Cohen wrote.

``Ultimately most physicians will shun an all-or-none approach'' and instead make case-by-case decisions, they said.

To contact the reporter on this story: Alex Nussbaum in New York anussbaum1@bloomberg.net.

Last Updated: September 24, 2008 16:01 EDT