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NEWS
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Advancement: Treating Heart Disease With Cholesterol
A recent study published in the Journal of the American Medical Association has shown that a new drug can potentially reverse heart disease. The treatment involves the use of a synthetic form of the "good cholesterol" HDL (high-density lipoprotein) that can rapidly shrink blockages in coronary arteries, reversing heart disease. Although the mechanism by which the synthetic form of HDL works to reduce plaques is still unclear, researchers think that it may function by transporting LDL (low-density lipoprotein) cholesterol, the cause of plaque buildup in arteries, to the liver where is it harmlessly processed and removed from the blood stream.
The synthetic form of HDL used in the study, named ApoA-1 Milano, is based on a rare type of naturally occurring HDL, discovered thirty years ago in a small group of abnormally healthy people with low cholesterol levels living in the northern Italian village of Limone Sul Garda. Despite having exceptionally low HDL levels, these villagers had an extremely low rate of heart disease, leading researchers to conclude that this somewhat unusual form of HDL provided potent protection against heart disease. After isolating this form of HDL, researchers were then able to synthetically produce it.
The study involved forty-seven patients at the Cleveland Clinic in Ohio. Thirty-six of the patients were given the synthetic HDL intravenously, and their plaque levels were measured before and after the study using an ultrasound technique that yields very precise and accurate results. After six weeks, these thirty-six showed a 4.2% reduction in arteriole plaque levels. The eleven-member control group, which received intravenous saline, showed no decrease in plaque levels. Researchers caution, however, that further studies must be conducted in order to verify the findings, assess the safety of the treatment, and conclude that the drug actually decreases the risk of heart attack.
Although only a preliminary study, the results have important and far-reaching implications. Currently, treatments available to high-risk patients and heart attack victims include LDL- and blood pressure-reducing drugs, such as Lipitor and Lotrel. These treatments, while effective preventive measures, do little to nothing to remove plaque buildup that is already present. The synthetic form of HDL used in the study, however, may be capable of bringing about such a reduction. The study's lead author, Cleveland Clinic cardiologist Steven E. Nissen, comments, "For the first time, we've shown that you can reverse coronary disease with drug therapy in a matter of weeks." Other leading members of the medical community agree that this treatment has the potential to revolutionize the way in which heart disease is treated. The clinical research director of the Montreal Heart Institute, Jean-Claude Tardif, remarks, "This isn't going to change clinical practice tomorrow, but it is going to change our thinking about cardiovascular disease in the years to come."
At this time, only long-term use of anti-cholesterol drugs and adherence to certain diets may lead to a reduction in arteriole plaques. Plaque reduction in these cases takes years and is small compared to what was seen in the patients treated with the synthetic HDLÑa fact that has researchers thrilled. Both Nissen and his colleague Daniel J. Radar, director of preventative cardiology at the University of Pennsylvania, agree that the most surprising result of the study was that plaque reduction could be induced in only a few weeks.
For the twelve million patients currently suffering from coronary heart disease, this new treatment offers hope of a cure for America's leading cause of death. While current treatments, although effective in preventing further damage, do little to help those already suffering from atherosclerosis, this new "Liquid Drano for the heart" can actually remove the plaques that are the source of many heart attacks. While it may be a few years until the actual benefits of the synthetic HDL are known and the treatment is commercially available, this discovery has opened a new door for research on how to treat heart disease.
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