International Study Led by VA-Harvard Physician Yields Insight on Risks from Fatty Arteries (forwarded from my office in box)

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International Study Led by VA-Harvard Physician

Yields Insight on Risks from Fatty Arteries

WASHINGTON (September 3, 2010)- An international study of clinical data
led by a Department of Veterans Affairs (VA)-Harvard University
cardiologist found that patients with deposits of fatty plaque in their
arteries are at especially high risk for life-threatening cardiovascular
events if they have diabetes, disease in multiple arteries or a history
of heart attack or stroke.

"This study was an impressive international collaboration that may hold
important clinical benefits for Veterans and others with cardiovascular
disease," said VA Secretary Eric K. Shinseki. "The results, presented
both in a prestigious medical journal and at a major international
cardiology meeting, are likely to be of great significance to
physicians-particularly cardiologists-in VA and worldwide."

The findings, from a study of more than 45,000 patients in nearly 30
countries, was published online August 30 by the Journal of the American
Medical Association and will appear in the journal's September 22 print
edition. The results are also being presented this week at the annual
meeting of the European Cardiology Society in Sweden.
According to lead author Dr. Deepak Bhatt and colleagues, the findings
may guide future clinical trials and help doctors decide which patients
need more aggressive treatment. Bhatt is chief of cardiology at the VA
Boston Healthcare System and director of the Integrated Interventional
Cardiovascular Program at VA and Brigham and Women's Hospital, a
teaching affiliate of Harvard Medical School.

The four-year study included patients who had at baseline clinical
evidence of atherothrombosis-in which fatty deposits break off from
artery walls to form clots-or who had risk factors for the condition.
Ruptured plaque deposits can form clots that block blood flow to the
heart or brain, resulting in heart attack or stroke.
Depending on their medical status and history, different groups of
patients in the trial were at higher or lower risk for stroke, heart
attack, or cardiovascular death. On the low end of the risk scale-7
percent-were those with no diabetes and only risk factors for
atherothrombosis. The risk rose to as high as 25 percent for those with
clinical evidence of atherothrombosis in multiple arteries and a history
of heart attack or stroke. The presence of diabetes also raised the risk
considerably.

"Even stable patients with a previous heart attack or stroke are at
particularly high risk of recurrence if they have plaque build-up in
several different arteries or if they have diabetes," said Bhatt. "These
types of patients need aggressive preventive efforts to keep history
from repeating itself."

Knowing that "not all atherothrombosis is equal," write Bhatt and
colleagues, can help doctors target therapies such as plaque-reducing
and clot-busting drugs to those patients who will benefit most. VA Chief
Research and Development Officer Dr. Joel Kupersmith adds, "this study
illustrates the importance of basic clinical information in determining
the best care for the individual patient."

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