"Drano" for Arteries

"Drano" for Arteries

December 2003
Volume III, Number 6

Scientists report that a breakthrough treatment may actually remove plaque from heart arteries--long considered the ultimate goal of cholesterol-lowering therapy.

"Until now, we have been fighting a rear-guard action, trying to slow down atherosclerosis and prolong the lives of the patients," Cleveland Clinic cardiologist Steven Nissen told NHW. "But the idea of actually reversing the disease has been a dream. We found that we could do it."

Study results published in the November 5 issue of JAMA show that five infusions of a synthetic version of HDL, the "good" cholesterol, given at one-week intervals, significantly reduced plaque volume in the heart's coronary arteries.

"Several years of accumulation were erased in a six-week period," says Dr. Nissen, who directed the nationwide trial. "It stunned everyone. We took what everybody--including me--believed to be a chronic, progressive disease and produced major changes in just weeks."

Ultrasound imaging tests verified plaque reduction in more than 30 of the 36 patients treated with the experimental compound.

"It will be several years before this HDL may become available," emphasizes Dr. Nissen. "The study is much more important in terms of what it tells us can happen if you treat with HDL. This will stimulate physician scientists, academics, the pharmaceutical industry, and the government to pursue this target, because we now know that it can work. That is the key."

HDL molecules consist of lipid (fat) and a protein component called ApoA-I. The drug used in this study mimics a genetic mutation in the protein first discovered among 40 individuals in Northern Italy who appeared perfectly healthy, despite having very low levels of good cholesterol. Known as ApoA-I Milano, the altered protein boosts HDL's ability to clear plaque from the artery walls. Other mutations of ApoA-1 are also under investigation.