Saturday, April 21, 2007

Finding the Cause of Heart Disease- Are We Barking Up the Right Tree?

The blockage of heart arteries is caused by a complex- not completely well understood- process called atherosclerosis. It is characterized by cholesterol deposits in the wall of the arteries that supply blood to the heart muscles. Why do some people have blockage of heart arteries and some do not? It could not just be the cholesterol we eat or manufacture in our body, because we do know that not everyone with high cholesterol has blocked heart arteries and some with perfectly normal cholesterol have heart attacks.

So what exactly causes blocked heart arteries? The simple answer is- we do not know for sure. Several theories have been suggested, however. Could this be due to some infection with a bug? Could this be inflammation? Studies that show that people with high level of C-reactive protein (CRP) are more likely to have heart problems seem to support inflammation theory.

Atherogenics is working on a class of drugs called v-protectants (vascular protectants). The basis for these drugs is that chronic inflammation underlies cardiovascular disease. Results from a phase III trial on compound AGI-1067 developed by Atherogenics were released. The study results reveal that the drug did not meet pre-defined measures of success- decrease in combination of cardiovascular deaths; resuscitated cardiac arrests; non-fatal heart attacks or strokes; need for bypass surgery or angioplasty to clear obstructed arteries; or urgent hospitalization for severe chest pain. The result of this trial prompted sharp fall in Atherogenics’ share price.

The result of this study raises another question- does this trial result simply signify failure of one drug or does it question inflammation hypothesis for development of cardiovascular disease?

Is inflammation a bystander, a result, or a cause of blockages of heart arteries? If inflammation is the cause of blocked heart arteries, what causes inflammation? Does some infection or any other agent cause it or is it there for no real reason? If it is due to a cause, will treatment of that cause be an effective solution for the cardiovascular problem? On the other hand, if it is just unbridled inflammation causing the damage, we should expect vascular protectants to help us attack the number one killer- cardiovascular disease- more effectively.
DrChander....Correction through action


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