Dr Pratiksha Gandhi is a preventive cardiologist working out of both Mumbai and Los Angeles. She is of the firm opinion that most angioplasties and bypass cardiac surgeries are avoidable. S Balakrishnan spoke to her to get details of her line of thinking on cardiac issues. Excerpts from an interview:
You say that most angioplasties and bypass surgeries are avoidable. On what basis are you saying this?
Studies funded by the National Institute of Health, USA, have demonstrated that stents and surgery are no more effective than medication and lifestyle changes in reducing cardiac events. In my practice over 20 years, I have discovered that over 80% of patients can be assisted with medications and lifestyle changes. Regrettably, in this commercialisation of medicine, patients are not given a chance or guidance to do so, and insurance does not cover lifestyle changes for patients.
Is it true that several cardiac surgeons and stent manufacturing companies started a campaign against you for your bold views?
The majority of hospital revenue is derived from cardiac procedures, making it natural for those who stand for truth and righteousness to be humiliated, rejected, bad-mouthed, and accused. However, I am not deterred, as we are doing right by the patients and will continue to do so. Whenever surgery is required, we recommend it ethically and do not suggest unnecessary surgeries or engage in malpractice. I have personally witnessed that hospitals are not serving patients honestly; when medicine is practised ethically, there isn't much money in it. If we are right, we must fight for a cause and not succumb to pressures.
You have done pioneering work in Enhanced External Counter Pulsation (EECP) therapy. How does it work?
EECP naturally increases blood supply to the heart without requiring any surgery, and can be completed in 35 hours. There are no incisions, no bleeding, no hospitalisation, and no scarring. It is a safe and effective treatment that is US FDA-approved for cardiac use. Originally, it was used as a treatment for failed bypass surgeries when I received my training in the USA in 2002. We were the first to popularise it on a mass scale in India as an alternative to bypass surgery. Dr Abdul Kalam appreciated our initiative. Now, India is a world leader in providing EECP therapy. In 2014, we published a research paper that demonstrated that EECP and bypass surgery have equivalent efficacy.
Does it have the approval of health authorities?
Yes, it is approved by the US FDA for cardiac use, and insurance reimburses it in the USA after bypass surgery fails. It is also included in the guidelines of the American College of Cardiology / American Heart Association at the level of evidence. This indicates that there is substantial evidence that the treatment works and most agree on its efficacy. However, more research and data are required for conclusive evidence.
How many people have you been able to save from angioplasty and bypass?
In the last two decades, we have conducted mass education campaigns and reached over 1,00,000 patients with our preventive programs. More than 10,000 patients have benefited from the EECP method. However, the majority of our patients are treated with lifestyle changes and medications. We recommend EECP therapy only when necessary and based on evidence. We conduct before and after studies on each patient to ensure positive outcomes.
What kind of work are you doing now?
Since founding the Institute of Preventive Cardiology (IPC) in 1999 as India's first female preventive cardiologist, my agenda has been to help people prevent heart attacks and avoid heart surgery whenever possible. We have spearheaded the 'Global Foundation for Preventive Cardiology to educate people worldwide on the prevention of heart attacks with free resources. We are striving to help more people with EECP and obtain more clinical data on our treatment so more people can trust it. We need help from the government and nonprofits to make this a mass movement.
