Arteries

LOS ANGELES -- A major new study of a cholesterol-lowering drug has found that it can shrink the fatty deposits in coronary arteries that are linked to heart attacks.The findings, in a study of the drug lovastatin, hold the promise that significant progress can ultimately be made in reducing the toll from heart disease, the leading killer in the United States and most developed countries.The results of the study add to the evidence that a low-fat diet and drugs can halt and reverse the buildup of fatty deposits, or plaque, in arteries in a process known as atherosclerosis, but it is the first suggestion that a single drug could have that effect.

Members of a cardiology trade group say they're worried that people will delay getting medical attention because they're afraid of receiving unnecessary cardiac stents, now that allegations against a Maryland physician have received national attention. The U.S. Senate Finance Committee released a report last month on stent usage at St. Joseph Medical Center in Towson, where Dr. Mark G. Midei is alleged to have placed the tiny mesh tubes, which prop open clogged arteries, into hundreds of patients who didn't need them.

A small clinical trial has shown for the first time that it is possible to use drugs to remove plaque from clogged arteries, a finding that could lead to radically new ways to treat heart disease, the No. 1 killer in the United States. Infusions of a genetically engineered mutant form of high-density lipoprotein, the so-called good cholesterol, over a five-week period were shown to reduce plaque volume in patients suffering from chest pain. "This is an extraordinary and unprecedented finding," said Dr. Steven E. Nissen of the Cleveland Clinic Foundation, who led the study reported in today's issue of The Journal of the American Medical Association.

When patients are in the throes of a heart attack, there's no question that stents save lives. But for heart patients with few symptoms and less than severe artery blockage, whether to use a stent is a question with no clear-cut answer, say cardiologists. In fact, these days some heart experts say the mesh metal tubes used to keep narrowed or weakened arteries propped open are overused for blockages that can be treated just as well with medicine, a healthy diet and exercise. A recent internal review of heart patients at St. Joseph Medical Center in Towson found 369 patients received the coronary implants unnecessarily.

Rob Alford, veteran heart patient, became a pioneer last week when tiny tubes were threaded into his clogged arteries. Doctors believe the devices could transform cardiac medicine. On Thursday, the U.S. Food and Drug Administration approved a new drug-coated stent that keeps scar tissue from choking newly unclogged arteries. The next day, Alford, a 50-year-old Bel Air resident, became one of the first patients in the country outside a clinical trial to get the new treatment. "This is the hottest thing in cardiology in years," said Dr. Mark Midei, the St. Joseph Medical Center physician who treated Alford.

St. Joseph Medical Center in Towson, whose cardiology business is a focus of a continuing federal health-care fraud investigation, has notified hundreds of its heart patients that they may have received expensive and potentially dangerous coronary implants they didn't need. An internal review, begun last May at the behest of federal investigators and in response to a patient complaint, has turned up 369 patients with stents that appear to have been implanted in their arteries unnecessarily, CEO Jeffrey K. Norman said in an interview yesterday.

Denver head coach Dan Reeves got a clean bill of health after a follow-up examination of his heart condition. A coronary angiogram -- involving inserting a tube into Reeves' heart, putting dye through it, and checking for blockage in the arteries around the heart -- was performed Thursday.In August, Reeves had chest pains and was diagnosed with blockage of the arteries. The next day he was flown to a hospital in Redwood City, Calif., where a procedure was performed to open up the arteries.

Heavy children have arteries of a 45-year-old obesity The arteries of many obese children and teenagers are as thick and stiff as those of 45-year-olds, a sign that such children could have severe cardiovascular disease at a much younger age than their parents unless their condition is reversed, researchers said Tuesday. "It's possible that they will have heart disease in their 20s and 30s," said Dr. Geetha Raghuveer of the University of Missouri at Kansas City, who led the study presented at a New Orleans meeting of the American Heart Association.

Wire mesh tubes called stents are widely used to prop open previously blocked coronary arteries - and they're often coated with drugs, which are thought to help keep the arteries open even more effectively. Recent studies, however, have shown that, in many cases, the arteries narrow again despite the drugs. Some physicians also suspect that drug-eluting stents are more dangerous than uncoated stents and that stents in general may irritate vessel walls. A small study presented at a national cardiologists' meeting and reported online on the New England Journal of Medicine Web site suggests an alternative for keeping the vessels from closing - coating the balloon used for angiography with a drug that inhibits plaque formation.

We know that ozone pollutes the air, seeps into the lungs and prompts health alerts that keep people indoors. Now add this to your ozone worry list - your body creates ozone, and it may cause heart disease. California researchers say the same ozone formed by the body's immune system to fight off infections in the bloodstream - a function discovered a year ago - may contribute to atherosclerois, a major killer. Although breathing ozone may hurt your respiratory system, it isn't damaging your arteries, according to researchers from the Scripps Research Institute in LaJolla.

St. Joseph Medical Center in Towson, whose cardiology business is a focus of a continuing federal health-care fraud investigation, has notified hundreds of its heart patients that they may have received expensive and potentially dangerous coronary implants they didn't need. An internal review, begun last May at the behest of federal investigators and in response to a patient complaint, has turned up 369 patients with stents that appear to have been implanted in their arteries unnecessarily, CEO Jeffrey K. Norman said in an interview yesterday.

Casey Kim points to the spot where the body of a woman hit by a car on U.S. 40 landed by the mailbox just in front of his Rosedale store in August 2006. Kim, owner of On Lok Liquors, said the victim, 38-year-old Melissa Dawn Sullivan of Baltimore, was one of four people killed in separate pedestrian crashes just outside his door since he took over the business six years ago. For more than five years , it has been the most dangerous spot on one of Maryland's most hazardous highways for people on foot.

Heavy children have arteries of a 45-year-old obesity The arteries of many obese children and teenagers are as thick and stiff as those of 45-year-olds, a sign that such children could have severe cardiovascular disease at a much younger age than their parents unless their condition is reversed, researchers said Tuesday. "It's possible that they will have heart disease in their 20s and 30s," said Dr. Geetha Raghuveer of the University of Missouri at Kansas City, who led the study presented at a New Orleans meeting of the American Heart Association.

Baltimore County Executive James T. Smith Jr. was "resting comfortably" yesterday after undergoing triple-bypass surgery in a Towson hospital, his aides said. The 66-year-old former judge, who was re-elected to his second term as head of the county government in 2006, checked himself into St. Joseph Medical Center on Tuesday after feeling pain in his chest. "He obviously did the right thing," said Dr. Stephen Pollock, the hospital's chief of cardiology and director of its Heart Institute.

On the X-ray image they printed out for me, trouble is a pink triangular speck, labeled LAD. The pink spot represents a calcium buildup - hardened plaque. And the LAD tag means the plaque lies in my "left anterior descending" coronary artery - the one cardiologists call "the widow maker." A blockage in the LAD tends to kill you. No one has said definitively that's what killed NBC newsman Tim Russert last week at the age of 58. But it wouldn't be a bad bet. Russert died after a heart attack in his Washington office.

To such well-known threats to the health of the Chesapeake Bay as nitrogen from farm fertilizers and runoff brought on by suburban sprawl, add a less-obvious danger: bacon grease. Homeowners who dump fat down the kitchen drain account for a growing share of sewage system overflows throughout Maryland. Most are minor, but grease buildup in a sewer line was blamed for a spill of more than a half-million gallons into woods next to the Patuxent River in Howard County this year. Yesterday, officials gathered on the banks of the Little Patuxent in Ellicott City's Centennial Park to call on cooks to be more careful.

The first physical explanation of why blacks are prone to high blood pressure, cardiovascular disease and strokes has been announced by researchers who say the findings may open the door to the development of new treatments.University of Georgia scientists found that arteries from black patients with severe heart disease were unable to return quickly to normal size after they had constricted in response to stress or medications. This relaxation is impaired, they found, because cells lining the arteries do not produce chemicals that stimulate enlargement.

Vice President Dick Cheney's recent problem with a clogged "stent" didn't surprise doctors who use the devices to reopen arteries of the heart. Many said they wouldn't be surprised if the stent clogs again, sending him back to the hospital for further treatment. But if that happens, it is likely that doctors will treat Cheney's problem with radioactive pellets, a new therapy for the heart borrowed from the world of oncology. The pellets have been used for many years to shrink tumors of the prostate and brain.

If you feel discomfort in your legs every time you go for a walk, it is possible that you have PAD, or peripheral arterial disease, particularly if you smoke or have diabetes, says Dr. Elizabeth Ratchford, assistant professor and director of the Clinical Vascular Medicine program at the Johns Hopkins School of Medicine's Division of Cardiology. Twenty percent of people 70 or older have symptomatic PAD, and many more people in that age group have PAD but do not experience the symptoms, according to the American Heart Association.

Leg pain is often dismissed as a sign of aging, but it could also be a sign of decreased blood flow to the limb, a condition known as peripheral arterial disease. The American Heart Association says more than 8 million people are affected by peripheral arterial disease (PAD), but nearly 75 percent may not know it because they do not experience any symptoms. But the disease can be indicative of more serious blockages elsewhere in the body. "If you look at 100 people who have peripheral arterial disease, within five years nearly a third will die because of heart attacks and strokes," says Dr. Mark Gonze, chief of vascular surgery at St. Joseph Medical Center.