Local cardiologists are urging Maine patients not to worry after a national study suggested that some people with non-emergency chest pain are getting unnecessary procedures to unclog their arteries when medication would have sufficed.

They say New England cardiologists are more conservative than those in other parts of the country and have been recommending drugs as a first option all along.

“We follow evidence-based medicine. We’re not there to be sort of cowboys and throw stents in everybody,” said Dr. William Phillips, director of interventional and diagnostic cardiology at the Central Maine Heart and Vascular Institute in Lewiston.

Released Monday, the study looked at nearly 2,300 patients throughout the U.S. and Canada. All had blockages and chest pain but were medically stable and not facing an emergency situation, such as a heart attack.

The study found that medication, including aspirin, ACE inhibitors, beta-blockers and other drugs worked just as well as angioplasty, a procedure in which doctors snake a tube to a blocked artery and inflate a tiny balloon to open the artery and restore blood flow. Usually a wire mesh stent is placed in the artery to hold it open.

In the study, drug patients and angioplasty recipients had similar rates of death, heart attack and heart-related hospitalizations. After three years, chest pain incidents were slightly higher for medication-only patients. After five years, chest pain incidents were virtually identical for both groups.

Local cardiologists largely met the results with a nod.

“This study doesn’t surprise me at all,” said Dervilla McCann, a cardiologist with the Androscoggin Cardiology Associates.

Both the American Heart Association and the American College of Cardiology recommend medication before angioplasty in certain non-emergency situations, she said. And she believes Maine cardiologists follow those guidelines.

“I’ve seen places that are kind of angioplasty mills. That doesn’t apply, by and large, to the places I know in Maine,” she said.

Cardiologists at CMMC, Maine Medical Center in Portland and Eastern Maine Medical Center in Bangor agree.

“It’s an important message for the national medical community to understand. But this is validating the way we do things in New England and here in Maine,” said Tom Ryan, cath lab director for Maine Medical.

In 2000, Maine Medical opposed the building of CMMC’s heart center, saying Lewiston-Auburn didn’t need it since the standard was to treat most heart patients with drugs before trying angioplasty and since Maine Med could perform any needed angioplasty in Portland.

CMMC said – and still says – an angioplasty center was needed in Lewiston, both for emergency heart attack patients and for non-emergency patients who live in the area.

Local cardiologists say every case is different and doctors need to evaluate what’s best for each patient. They might recommend medication in certain non-emergency cases because a patient’s chest pain is due to another problem, such as a gastrointestinal disorder, and stenting the artery won’t change that. Or when the patient has only mild angina – pain because the heart isn’t getting enough oxygen – and can’t wait for the drugs to take effect. Or when the patient has other health problems that make angioplasty risky.

There are times doctors recommend angioplasty in non-emergency situations, such as when a patient has a lot of chest pain from a blockage and can’t tolerate it long enough for the drugs to work. But local doctors say that doesn’t happen often.

The vast majority of the angioplasties they do, they say, are for heart attack patients, a practice that is not in question.

“We try to use good clinical judgment and guidelines,” said Peter VerLee, director of Eastern Maine Medical’s cardiac cath lab.