The Business Press Maven, whose only chance of getting to medical school was as a cadaver, is stunted when it comes to underlying knowledge of the effectiveness of heart stents. For once: I have no opinion. My modest level of medical knowledge helps me realize only two things.
One: Drug-coated stents are tiny tubes used to permanently prop open clogged arteries and were thought to be more effective than the old bare metal kind, because they also emit drugs designed to cut down on clogging. Thought to do double duty, these stents became big business for companies like
Johnson & Johnson
Two: In the medical field in general, with so much money and visibility at stake, doctors, academics and medical companies all vie for public notice, which translates into everything from big profits to respectful nods in the faculty lounge.
Now add in the business media, which has all the subtlety of a pile driver and always needs material and thus often writes about medical issues with absolutism. But when you have researchers scheming for publicity on the one hand and the business media prone to take the bait and make big new pronouncement on the other, what you get, my patient, is a confusing mess, with symptoms of wildly swinging, contradictory headlines over time.
The cure, investors, is to never overreact to alarmist -- or, their frequent corollary, all-clear -- headlines in the medical field. There is no better example that in the articles we've seen over drug-eluting heart stents in the past year. Reading back over them is enough to make a guy need to pop a nitro pill.
The Boston Globe
, for one, ran an
story almost exactly a year ago with the panicky headline: "
Concerns increase on drug-coated heart stents." The dateline was Barcelona, and from the great home of La Rambla came this scary pronouncement: "Specialists expressed concerns yesterday that drug-coated heart stents -- metal-mesh tubes used to prop open coronary arteries -- might increase the chances of potentially fatal blood clots."
The World Cardiology Conference was meeting and a Swiss-Dutch study was presented that said there might very well be increased risk to the 6 million people who have drug-lined stents. The older, less-profitable kind might be better. The only quotes in the article were full-force scary. One mentioned that this was "potentially explosive information," the other about "substantial concern."
Nothing in the article raised an eyebrow about the study, and a previous one that had reached similar conclusions was mentioned in a kicker to the article that had a double negative that caused my tongue to need immediate medical care:"Doubts about drug-coated stents were initially raised in March by a small-scale Swiss study, although there have long been naysayers about their potential adverse effects."
Long been naysayers about the adverse effects? Does that mean, like, they thought they were good? Hard to tell.
Anyhow, the business media then had what it always gravitates toward: controversy, disagreement and creative tension. Mind you: they are not totally at fault for this. There was a considerable amount of discussion on the topic among doctors and Wall Streeters alike as investors were asking about the new stents, which were seeing sales trailing off. But the point is: it was in large part caused by the coverage of the Barcelona meeting, which was harnessed to that first Swiss study, and (here's the key) the use of such absolute terms in the reporting.
Doctors Rethink Widespread Use of Heart Stents," we soon heard from
The New York Times
The Business Press Maven is a bit more critical of an article that occurred a week before. Into this highly charged environment came a headline: "
Newer Stents Post Dangers, 2 Doctors Say."
The article was about a much-criticized online editorial by two doctors who happened to say that the drug-eluting stents were killing thousands. The Food and Drug Administration would soon have safety hearings, also well covered, inviting one of the original Swiss researchers, referred to in the
piece, to prattle on about how much more likely you were to die with drug-eluting stents.
Now, fast forward to the present, and recall that
The Associated Press
started much of the panic between tapas in Barcelona.
Well, on Sept. 3 of this very year, the esteemed news agency ran with this teensy-weensy article, which was about the size of a stent: "
Data Improves for Heart Stents." But The Business Press Maven nearly had the Fred Sanford big one when I read this:
Last year, research suggested that the devices were responsible for an increased number of fatal blood clots. But on Sunday, Dr. Stefan James of the Uppsala Clinical Research Center in Sweden presented follow-up results to the European Society of Cardiology conference in Vienna. With more patients and an extra year of data, a different story emerged. After four years of tracking patients with the drug-coated stents, Dr. James said the results showed no significant difference between patients who received the drug stents and those who received bare metal ones. In December, Dr. James told a Food and Drug Administration safety hearing that research indicated that patients with drug-emitting stents had an 18 percent increased chance of dying compared with patients with bare metal stents.
You know, of course, what comes next. Unlike investors or even heart patients, the business media does not have to take a single stand. They can ride a story both ways. Here is a
New York Times
headline from just last week: "
Studies Say Newer Stents for Arteries Show Promise."
And, just in case you didn't get the memo that everything is perfect now and to show you how full circle the discourse has come, consider this headline from today: "
New Study Favorable to Drug-Coated Stents."
Most importantly, to my Jewish readers, a wish for the happiest and healthiest of New Year's. But lay off the kasha varnishkes -- too much chicken fat is bad for the heart.
At the time of publication, Fuchs had no positions in any of the stocks mentioned in this column.
A journalist with a background on Wall Street, Marek Fuchs has written the County Lines column for The New York Times for the past five years. He also contributes regular breaking news and feature stories to many of the paper's other sections, including Metro, National and Sports. Fuchs was the editor-in-chief of Fertilemind.net, a financial Web site twice named "Best of the Web" by Forbes Magazine. He was also a stockbroker with Shearson Lehman Brothers in Manhattan and a money manager. He is currently writing a chapter for a book coming out in early 2007 on a really embarrassing subject. He lives in a loud house with three children. Fuchs appreciates your feedback;
to send him an email.