Heart Disease & Stroke - Progress (cont.)

This list was issued at the end of 1999 by the American Heart Association and is based upon developments reported during 1998. We will comment upon each of these ten advances:

1. Gene therapy to create a "natural" bypass to circumvent plaques obstructing the heart's blood vessels.

People with heart disease may be routinely treated in the future by a genetically engineered technique that induces the growth of new blood vessels. The new vessels would help restore blood flow to the hearts of people whose arteries are obstructed by plaques. By impeding blood flow, these obstructions can cause severe chest pain (angina) and heart attacks.

Scientists reported that they had used a human growth factor called FGF-1 (fibroblast growth factor-1), obtained through genetic engineering, to induce the growth of new blood vessels in 20 patients with heart disease. In their three-year follow-up study of the patients, the scientists reported that the treatment resulted in a two to three times more blood flow to the heart.

Another growth factor called VEGF (vascular endothelial growth factor) also appears capable of inducing new blood vessel growth for the heart. Gene therapy may thus become an important part of the treatment of heart disease.

2. New drugs to prevent clots causing heart attacks and strokes.

Drugs called platelet blockers (or, more formally, IIb/IIIa receptor blockers) were found to keep blood platelets from clumping and forming blood clots that can trigger a heart attack or stroke. In this regard they are like aspirin. However, the platelet blockers -- eptifibatide (brand name: Integrilin), tirofiban (Aggrastatin) and abciximab (ReoPro) -- are more potent than aspirin. And they are administered intravenously (IV).