Heart Disease: Blocking Buildup

Even a small increase in plaque buildup inside the coronary arteries means bad news for heart patients, according to a recent analysis of six clinical trials by researchers at Cleveland Clinic.

The researchers assessed plaque growth in 4,317 patients over an 18- to 24-month period, using intravascular ultrasound, a widely used technology that takes 360-degree images inside the artery walls. The results, published in the May 25 Journal of the American College of Cardiology, found heart patients with a plaque buildup of less than 1 percent during this time had more heart attacks and required more bypass surgery or angioplasties than patients whose plaque remained stable.

“It’s a pivotal finding,” says study author Steven Nissen, MD, Chief of Cardiovascular Medicine at Cleveland Clinic and the Lewis and Patricia Dickey Chair in Cardiovascular Research. Scientists years ago identified predictors of plaque growth, such as smoking or high cholesterol, but this finding goes further, he says: “These studies indicate that slowing the disease even a little bit can translate into fewer heart attacks.”

By mid-2011, further proof should be available with completion of a Cleveland Clinic study comparing cholesterol-lowering drugs Crestor® (rosuvastatin calcium) and Lipitor® (atorvastatin calcium). About 1,300 patients are already enrolled in the trial — which Dr. Nissen calls “the battle of the titans” — to determine which drug does a better job of shrinking plaque and keeping worsening disease at bay.