Coronary artery disease
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of CAD.
Alternative Names
Angina; Atherosclerosis; Heart disease
Highlights
Drug Approvals
Ranolazine (Ranexa) has been approved for the treatment of chronic angina. This new type of drug is prescribed in combination with other anti-angina drugs.
Homocysteine and B Vitamins
Vitamin B supplements do not help prevent heart disease, according to several studies in the
New England Journal of Medicine
. Researchers studied whether folic acid, B6, and B12 vitamin supplements could reduce heart disease risk by lowering levels of homocysteine. (Increased levels of this amino acid are associated with increased risks for heart disease and stroke.) While the vitamins did lower homocysteine levels, they had no effect on heart disease outcomes. Some experts now think that increased homocysteine levels may be a sign of heart disease, rather than a cause of it.
Aspirin and Clopidogrel
A combination of aspirin and clopidogrel (Plavix) may not work better than aspirin alone for patients at risk for a first heart attack or stroke, suggests a study in the
New England Journal of Medicine
. However, experts emphasize that the drug combination is still important for many patients with heart disease, especially those who undergo stenting. Do not stop taking clopidogrel without talking to your doctor.
Statin Drugs
Statin drugs may be able to reverse coronary artery disease, suggests a study in the
Journal of the American Medical Association
. The study found that rosuvastatin (Crestor) reduced fatty build-up in clogged arteries. Future research will determine if other statins have a similarly positive effect.
Drug-Coated Stents
Inserting a drug-coated stent into a bare metal stent may be better than radiation therapy for reopening clogged arteries, suggests several 2006 studies. Bare metal stents are often used during angioplasty to open blocked arteries, but they tend to become clogged. Treatment with tiny radioactive pellets is the only approved treatment for failed stents.
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Review Date: 4/12/2006
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Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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