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    HEART NEWS

     

    HEART NEWS

    Cardiologists, surgeons and others are investigating therapies ranging from the use of a laser to burn tiny holes into the heart muscle to relieve chest pain (angina) to drinking red wine to head-off heart disease - the leading killer of Americans.

    Results of their research were presented at the 49th annual scientific session of the American College of Cardiology (ACC) - a professional society whose membership comprises more than 24,000 cardiovascular physicians and scientists from around the world.

    Among the most important presentations - from a patient standpoint - were two studies indicating that using lasers that have been threaded into the heart's main pumping chamber (the left ventricle) may give relief to people with heart disease so bad that they are barely able to walk. The only question, according to researchers, is why does the treatment work?

    Lasers are used to make tiny channels within the heart muscle in an attempt to improve blood flow. This technique, called transmyocardial revascularization (TMR), has in the past required chest surgery. Now, a method, known as percutaneous transmyocardial revascularization (PTMR), starts by threading the laser through an artery in the leg and directing it into the heart's left ventricle. Once inside, the laser burns a dozen or more tiny holes into the wall of the heart.

    of the Texas Heart Institute, described his experimental use of this laser procedure in a study of 325 people who were randomly assigned to PTMR or medical management. One year later, 55 percent of those who received the laser treatment had substantially less chest pain, compared with 31 percent assigned to medical management. The laser-treated group also could walk on a treadmill for about 90 seconds longer after the treatment, while those on medical management had a 16-second decline in treadmill time.

    Hormone replacement therapy (HRT)

    Another study presented at the conference found that hormone replacement therapy (HRT) does not slow the progress of heart disease in postmenopausal women.

    Cholesterol-lowering drugs

    Several other studies highlighted the value of lipid-lowering drugs, especially statins such as atorvastatin (Lipitor), simvastatin (Zocor), and lovastatin (Mevacor), in improving the outcomes of people with heart disease.

    *

    Researchers at Wilford Hall Medical Center in San Antonio investigated the effects of long-term treatment with lovastatin on the need for angioplasty or bypass surgery to improve blood flow in people with heart disease. The 5-year study of more than 6,000 men and women without evidence of coronary artery disease found that lovastatin treatment significantly reduced the overall rate of those having to undergo angioplasty, bypass surgery or a similar procedure. Lovastatin also appeared to reduce the incidence and severity of disease, the researchers said.
    *

    A study by researchers, Rochester, Minn., found that statins appear to be beneficial, even when given hours after a heart attack. The researchers tracked the outcomes of 66 people admitted to the hospital due to a heart attack and who were taking a statin drug at the time of admission or who began statin therapy within 24 hours of admission. Compared to a control group, the patients treated with statins had a significantly lower death rate and fewer complications.
    *

    A study at Long Beach Veterans Administration Medical Center in California evaluated the effects of combining lovastatin and niacin in more than 800 people with high cholesterol levels. After 16 weeks of therapy, low-density lipoprotein (LDL, the "bad" cholesterol) was reduced by 47 percent and triglyceride levels dropped by 42 percent. Levels of high-density lipoprotein (HDL), the "good" cholesterol, increased by 30 percent.

     






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