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American Morning

Heart Health

Aired November 05, 2003 - 07:47   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.


BILL HEMMER, CNN ANCHOR: They say it works like liquid drain cleaner for clogged arteries. A new study says intravenous doses of a synthetic form of HDL, or good cholesterol, can remove plaque from arteries in a matter of weeks. What could this mean now for treatment of the nation's No. 1 killer? A good question.
Dr. Steven Nissen of the Cleveland Clinic led that study. He's live this morning from northern Ohio.

Doctor, good morning to you.

DR. STEVEN NISSEN, CLEVELAND CLINIC: Good morning.

HEMMER: Here's the way I understand it now. In the past, you give drugs to those to help lower the LDL, or the bad cholesterol. This, though, focuses on raising the HDL, or the good cholesterol. How does that work when they counter each other?

NISSEN: Well, it's really very interesting. We understand that the bad cholesterol is what's driving the plaque into the wall of the artery, and the HDL, the good cholesterol, is removing plaque, carrying it back to the liver and excreting it. And so, we propose that if we gave this special form of good cholesterol, obtained from these individuals in this Italian village, that we could clean out the arteries relatively quickly.

What's really surprising, almost astonishing, is how quickly it worked. 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. This was a really surprising result.

HEMMER: What's so special about this village in Italy?

NISSEN: Well, it's almost a fairy tale story. A 40-year-old man walks into his physician's office in 1974, and he's perfectly healthy, but his HDL level is only 7. That's off the bottom of the scale. It's really so low, you'd expect these people to have heart disease in their 20s or 30s or 40s. Well, fortunately, the physicians there investigated, and they found 38 individuals in this village that had exactly the same problem -- low HDL, but no apparent heart disease. And it turns out that they have a genetic mutation that makes their HDL just slightly different from the rest of us.

And now here we are, 30 years later, and a small biotechnology company has turned that HDL into a drug. We had the opportunity to give it to patients after heart attacks, and lo and behold it removes the plaque from the coronary arteries. It's really an amazing story.

HEMMER: One wonders if this is olive oil and red wine at work yet again here. I have a graphic to show our viewers here, the before and after affect. Take us through what we're seeing here, so we can better understand this, Doctor.

NISSEN: Well, I can't see what you're looking at, so...

HEMMER: There's a before treatment on the left and after six weeks of therapy. It's quite clear right now that this is figure four from your study.

NISSEN: Ah!

HEMMER: And so long as you have that description, tell us what we need to know.

NISSEN: Well, on the left side, what you'll see is that there is a pretty large plaque that measured about a little more than eight square millimeters. And on the right side after five weeks of treatment, you see the plaque is down to 5.35 square millimeters. That's a 34-percent reduction in the area of the plaque in just five weeks.

If you had told me that we could see that in an individual, I wouldn't have believed you until we actually did the study.

HEMMER: One final thought here. Only 57 patients involved in this study. I am told through a number of doctors over the years that that is not a very large number at all to reach any sort of conclusions here. What do you do now? Do you take it to a larger study and try and buffer the argument right now?

NISSEN: Absolutely. And I think it is important to understand for everyone that this is not an available therapy. It's investigational. But we are so encouraged by these results that now we have a good reason to do studies in thousands of patients. And I'm really very confident that when we go ahead and study this in a larger group, we're going to find that targeting the HDL, the good cholesterol, can actually turn around this disease, and it can do it much faster than we ever believed.

HEMMER: Thank you, Doctor. Steven Nissen with the Cleveland Clinic. We'll check in down the road when we get more. Thank you.

NISSEN: Thank you.

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 5, 2003 - 07:47   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: They say it works like liquid drain cleaner for clogged arteries. A new study says intravenous doses of a synthetic form of HDL, or good cholesterol, can remove plaque from arteries in a matter of weeks. What could this mean now for treatment of the nation's No. 1 killer? A good question.
Dr. Steven Nissen of the Cleveland Clinic led that study. He's live this morning from northern Ohio.

Doctor, good morning to you.

DR. STEVEN NISSEN, CLEVELAND CLINIC: Good morning.

HEMMER: Here's the way I understand it now. In the past, you give drugs to those to help lower the LDL, or the bad cholesterol. This, though, focuses on raising the HDL, or the good cholesterol. How does that work when they counter each other?

NISSEN: Well, it's really very interesting. We understand that the bad cholesterol is what's driving the plaque into the wall of the artery, and the HDL, the good cholesterol, is removing plaque, carrying it back to the liver and excreting it. And so, we propose that if we gave this special form of good cholesterol, obtained from these individuals in this Italian village, that we could clean out the arteries relatively quickly.

What's really surprising, almost astonishing, is how quickly it worked. 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. This was a really surprising result.

HEMMER: What's so special about this village in Italy?

NISSEN: Well, it's almost a fairy tale story. A 40-year-old man walks into his physician's office in 1974, and he's perfectly healthy, but his HDL level is only 7. That's off the bottom of the scale. It's really so low, you'd expect these people to have heart disease in their 20s or 30s or 40s. Well, fortunately, the physicians there investigated, and they found 38 individuals in this village that had exactly the same problem -- low HDL, but no apparent heart disease. And it turns out that they have a genetic mutation that makes their HDL just slightly different from the rest of us.

And now here we are, 30 years later, and a small biotechnology company has turned that HDL into a drug. We had the opportunity to give it to patients after heart attacks, and lo and behold it removes the plaque from the coronary arteries. It's really an amazing story.

HEMMER: One wonders if this is olive oil and red wine at work yet again here. I have a graphic to show our viewers here, the before and after affect. Take us through what we're seeing here, so we can better understand this, Doctor.

NISSEN: Well, I can't see what you're looking at, so...

HEMMER: There's a before treatment on the left and after six weeks of therapy. It's quite clear right now that this is figure four from your study.

NISSEN: Ah!

HEMMER: And so long as you have that description, tell us what we need to know.

NISSEN: Well, on the left side, what you'll see is that there is a pretty large plaque that measured about a little more than eight square millimeters. And on the right side after five weeks of treatment, you see the plaque is down to 5.35 square millimeters. That's a 34-percent reduction in the area of the plaque in just five weeks.

If you had told me that we could see that in an individual, I wouldn't have believed you until we actually did the study.

HEMMER: One final thought here. Only 57 patients involved in this study. I am told through a number of doctors over the years that that is not a very large number at all to reach any sort of conclusions here. What do you do now? Do you take it to a larger study and try and buffer the argument right now?

NISSEN: Absolutely. And I think it is important to understand for everyone that this is not an available therapy. It's investigational. But we are so encouraged by these results that now we have a good reason to do studies in thousands of patients. And I'm really very confident that when we go ahead and study this in a larger group, we're going to find that targeting the HDL, the good cholesterol, can actually turn around this disease, and it can do it much faster than we ever believed.

HEMMER: Thank you, Doctor. Steven Nissen with the Cleveland Clinic. We'll check in down the road when we get more. Thank you.

NISSEN: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com.