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Heart Disease Health Center

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Breakthroughs in Atherosclerosis Treatment

New research may lead to new drugs for heart disease.

Anti-inflammatories for the heart

Still, researchers are cautiously hopeful because other experiments continue to show promise, he adds, including one in which researchers infused HDL preparations into people who had the disease and found that atherosclerosis regressed in artery walls in as little as four or five weeks. “I think that there’s clear evidence that if you directly give HDL, it’s a good thing,” Nicholls says. “But the complexity of HDL is that it may be that not all forms of HDL are protective. For that reason, it’s going to be about finding the right therapy that raises the right kind of HDL and has the best chance at reducing cardiac risk.”

Besides HDL therapies, “the second area of interest is clearly the inflammation story,” Nicholls says. In general, researchers agree inflammation plays a key role in plaque formation and subsequent plaque rupture, which can lead to a heart attack, Nicholls says. Some drugs, such as statins, lower LDL cholesterol and may also have anti-inflammatory effects, he adds. However, researchers hope to develop entirely new types of drugs that specifically prevent or reduce inflammation in artery walls, perhaps by attacking root causes.

Although no anti-inflammatory therapy to date has reached an advanced stage in clinical trials, “it’s clearly a very important area because it would seem to be an obvious complement to the therapies we already have, if we can show they work,” he says.

Imaging atherosclerosis

Advances in computed tomography, positron emission tomography, and magnetic resonance imaging are allowing researchers to study atherosclerotic plaque in greater detail, sometimes down to the cellular level. The various imaging techniques can examine artery wall thickness, amount of blockage, and composition and metabolic activity of plaque.

Right now, the imaging advances are in clinical trials, and none has progressed to the point of being able to predict a person’s coronary risk, according to Zahi A. Fayad, PhD, a Mount Sinai School of Medicine researcher in New York City who has investigated imaging of plaques. Instead, scientists are using the new techniques to help assess effectiveness of therapies. For example, through imaging, scientists can check whether a certain treatment is causing plaque to regress.

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