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CNN Live Saturday
New Drug Acts As "Liquid Drano" For Clogged Arteries
Aired November 08, 2003 - 14:41 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KELLI ARENA, CNN ANCHOR: A new treatment may be a revolutionary breakthrough for those at risk for heart disease. A synthetic substance can actually remove fatty buildup from arteries. We'll talk about the treatment with our guest in a moment. But first, medical correspondent Christy Feig explains how it came about.
(BEGIN VIDEOTAPE)
CHRISTY FEIG, CNN MEDICAL CORRESPONDENT (voice-over): Researchers at the Cleveland Clinic had created what they describe as a liquid Drano for clogged arteries. The idea came from a small village in northern Italy, researchers found the people there carried a mutation in their good cholesterol and they didn't develop heart disease, no matter how little of protection they it.
DR. STEVEN NISSEN, CLEVELAND CLINIC: You'd expect these people to have heart disease in there 20s, 30s or 40s.
FEIG: So the researchers created a synthetic version and tested it in 36 patients after just 6 weeks the amount of fatty plaque in their arteries was actually reduced by 4 percent. Experts say that significant. Because most current treatments work to stop progression of heart disease, not reverse it. Researchers were surprised how quickly it worked.
NISSEN: The therapies we've had in the past have taken years to affect the disease. We found that only five doses of this super HDL reduced the plaque burden in the coronary arteries.
FEIG: The researchers are quick to point out the results are early and it will take larger trials to determine what this means in the long run. Doctor Sydney Smith, past president of the American Heart Association, says we need to know that the improved coronary images at five weeks will translate into more patients alive with fewer heart attacks in five years. The researchers plan to continue studies, if successful, it will still be several years before it's on the market. Christy Feig, CNN, Washington.
(END VIDEOTAPE)
ARENA: Well Dr. Herb Aronow was an assistant professor at the University of Pennsylvania School of Medicine. He's in Philadelphia to talk about this new cholesterol treatment. Doctor, thank you for joining us.
DR. HERB ARONOW, UNIVERSITY OF PA SCHOOL OF MEDICINE: Kelli, a pleasure to be here. ARENA: Explain to me exactly how this works. Do you have to be sick first, or is this a preventative measure?
ARONOW: Well, I think first we should simply take a step back and say that cardiovascular disease, that is the buildup of plaque inside our arteries is the number one cause of death and disability in our country and around the globe, and we've known now for decades that high levels of bad cholesterol, LDL cholesterol are associated with the development of cardiovascular events, like sudden death, and heart attack and stroke.
We're pretty good about treating that and we've got some very powerful medicine that hammer down levels of bad cholesterol, but we haven't been able to do, is effectively treat low levels of good cholesterol, which also are associated with increased risk of having those same events.
So this medication termed APO-A1 Milano, was administered in Dr. Nissen's study, actually was able to through only five intravenous infusions over a very short period of time, less than six weeks, regress, or almost melt away some of the plaque that had built up in their arteries, and as mentioned in the package earlier, what is remarkable about that is that this process starts when we're teenagers. So it's been ongoing for decades and yet in only five weeks, we already can see some improvement.
ARENA: With any side effects?
ARONOW: There certainly can be side effects with any medication, and at least as reported in the article in this week's "Journal of the American Medical Association" most side effects weren't significantly increased over those in the placebo or dummy arm. The placebo arm is just a salt-water infusion, there appeared to be slightly more headache in the group of patients who received the treatment, APO-A1 Malano, whether they were statistically significant.
ARENA: How long does it last? I mean how long do arteries remain clear?
ARONOW: That is a great question. I mentioned this process starts when we're fairly young. And so the question is, if five weeks does some good. How many weeks is the right length? In other words is this a lifelong therapy, is this something that somebody could go on for a month? I don't think we yet have the answer to that question.
ARENA: Who do you think are the best candidates for this type of procedure?
ARONOW: I certainly think we should start with people who already have plaque buildup in their arteries, whether it is their heart arteries or perhaps the arteries to the brain, or the kidneys or arms or legs. This disease really affects arteries all over the body. I think once we're able to prove that not only can we melt away plaque but perhaps reduce the chance of having an event like a sudden death or a heart attack or a stroke, but then we can move on to lower risk populations, like those at risk for disease, but those in whom disease is not yet present.
ARENA: Do you foresee this being used as a preventative measure rather than one that reacts to a problem?
ARONOW: Again, I think that first we ought to start with those who have the disease, but I think that you really hit on an important point here. And that is, that the key to reducing the burden of cardiovascular disease takes on the society is prevention. I say that because perhaps half of all people with cardiovascular disease have, as a first manifestation of that disease, sudden death. They never make it to our attention and there's never anything we can do about it. So, yes, I think you're right. There's certainly a role here for prevention. Now that being said, medication isn't the only thing that that can be used for prevention. I think we need to remind our viewers --
ARENA: Diet I assume.
ARONOW: Diet, smoking cessation, exercise, all of those not only increase your HDL, or good cholesterol, but they lower your LDL, or bad cholesterol and appear to be a benefit in reducing those events that I noted earlier.
ARENA: All right, all the stuff nobody likes to hear.
ARONOW: It's nice to just hope you can keep doing all the things you do you shouldn't and take the medication. But these are really complimentary strategies.
ARENA: OK, Dr. Aronow, thank you for joining us.
ARONOW: Thank you.
ARENA: Sounds very promising.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired November 8, 2003 - 14:41 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KELLI ARENA, CNN ANCHOR: A new treatment may be a revolutionary breakthrough for those at risk for heart disease. A synthetic substance can actually remove fatty buildup from arteries. We'll talk about the treatment with our guest in a moment. But first, medical correspondent Christy Feig explains how it came about.
(BEGIN VIDEOTAPE)
CHRISTY FEIG, CNN MEDICAL CORRESPONDENT (voice-over): Researchers at the Cleveland Clinic had created what they describe as a liquid Drano for clogged arteries. The idea came from a small village in northern Italy, researchers found the people there carried a mutation in their good cholesterol and they didn't develop heart disease, no matter how little of protection they it.
DR. STEVEN NISSEN, CLEVELAND CLINIC: You'd expect these people to have heart disease in there 20s, 30s or 40s.
FEIG: So the researchers created a synthetic version and tested it in 36 patients after just 6 weeks the amount of fatty plaque in their arteries was actually reduced by 4 percent. Experts say that significant. Because most current treatments work to stop progression of heart disease, not reverse it. Researchers were surprised how quickly it worked.
NISSEN: The therapies we've had in the past have taken years to affect the disease. We found that only five doses of this super HDL reduced the plaque burden in the coronary arteries.
FEIG: The researchers are quick to point out the results are early and it will take larger trials to determine what this means in the long run. Doctor Sydney Smith, past president of the American Heart Association, says we need to know that the improved coronary images at five weeks will translate into more patients alive with fewer heart attacks in five years. The researchers plan to continue studies, if successful, it will still be several years before it's on the market. Christy Feig, CNN, Washington.
(END VIDEOTAPE)
ARENA: Well Dr. Herb Aronow was an assistant professor at the University of Pennsylvania School of Medicine. He's in Philadelphia to talk about this new cholesterol treatment. Doctor, thank you for joining us.
DR. HERB ARONOW, UNIVERSITY OF PA SCHOOL OF MEDICINE: Kelli, a pleasure to be here. ARENA: Explain to me exactly how this works. Do you have to be sick first, or is this a preventative measure?
ARONOW: Well, I think first we should simply take a step back and say that cardiovascular disease, that is the buildup of plaque inside our arteries is the number one cause of death and disability in our country and around the globe, and we've known now for decades that high levels of bad cholesterol, LDL cholesterol are associated with the development of cardiovascular events, like sudden death, and heart attack and stroke.
We're pretty good about treating that and we've got some very powerful medicine that hammer down levels of bad cholesterol, but we haven't been able to do, is effectively treat low levels of good cholesterol, which also are associated with increased risk of having those same events.
So this medication termed APO-A1 Milano, was administered in Dr. Nissen's study, actually was able to through only five intravenous infusions over a very short period of time, less than six weeks, regress, or almost melt away some of the plaque that had built up in their arteries, and as mentioned in the package earlier, what is remarkable about that is that this process starts when we're teenagers. So it's been ongoing for decades and yet in only five weeks, we already can see some improvement.
ARENA: With any side effects?
ARONOW: There certainly can be side effects with any medication, and at least as reported in the article in this week's "Journal of the American Medical Association" most side effects weren't significantly increased over those in the placebo or dummy arm. The placebo arm is just a salt-water infusion, there appeared to be slightly more headache in the group of patients who received the treatment, APO-A1 Malano, whether they were statistically significant.
ARENA: How long does it last? I mean how long do arteries remain clear?
ARONOW: That is a great question. I mentioned this process starts when we're fairly young. And so the question is, if five weeks does some good. How many weeks is the right length? In other words is this a lifelong therapy, is this something that somebody could go on for a month? I don't think we yet have the answer to that question.
ARENA: Who do you think are the best candidates for this type of procedure?
ARONOW: I certainly think we should start with people who already have plaque buildup in their arteries, whether it is their heart arteries or perhaps the arteries to the brain, or the kidneys or arms or legs. This disease really affects arteries all over the body. I think once we're able to prove that not only can we melt away plaque but perhaps reduce the chance of having an event like a sudden death or a heart attack or a stroke, but then we can move on to lower risk populations, like those at risk for disease, but those in whom disease is not yet present.
ARENA: Do you foresee this being used as a preventative measure rather than one that reacts to a problem?
ARONOW: Again, I think that first we ought to start with those who have the disease, but I think that you really hit on an important point here. And that is, that the key to reducing the burden of cardiovascular disease takes on the society is prevention. I say that because perhaps half of all people with cardiovascular disease have, as a first manifestation of that disease, sudden death. They never make it to our attention and there's never anything we can do about it. So, yes, I think you're right. There's certainly a role here for prevention. Now that being said, medication isn't the only thing that that can be used for prevention. I think we need to remind our viewers --
ARENA: Diet I assume.
ARONOW: Diet, smoking cessation, exercise, all of those not only increase your HDL, or good cholesterol, but they lower your LDL, or bad cholesterol and appear to be a benefit in reducing those events that I noted earlier.
ARENA: All right, all the stuff nobody likes to hear.
ARONOW: It's nice to just hope you can keep doing all the things you do you shouldn't and take the medication. But these are really complimentary strategies.
ARENA: OK, Dr. Aronow, thank you for joining us.
ARONOW: Thank you.
ARENA: Sounds very promising.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
