`01 Had Breakthrough in Angioplasty
... a new drug effective against an unusual digestive cancer called gastrointestinal stromal tumors.......It is also being tested in lung, prostate and brain cancer. Standard chemotherapy goes after all fast-dividing cells and kills them indiscriminately....
Dec 17 2:21 PM ET
Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)
Posted on: 12/18/2001
'01 Had Breakthrough in Angioplasty
By DANIEL Q. HANEY, AP Medical Editor
Measured by headline size, the top medical stories of the year
were the anthrax scare, the stem cell controversy and the
artificial heart. But some doctors say a less heralded breakthrough
may be the biggest news of all, for it will soon improve treatment
for hundreds of thousands of Americans with heart disease.
The development is a surprising improvement in the way doctors
do angioplasties, one that promises to keep these routine
procedures from going bad so they can be done in more people who
In almost every area of medicine - cancer, diabetes, infectious
diseases and more - scientists are making impressive strides, using
a molecule-by-molecule understanding of disease to design drugs and
devices that tackle the illnesses at their roots.
The latest innovation in treating heart disease shows how this
basic understanding pays off. It grows from an intimate knowledge
of how smooth muscle cells pile up inside blood vessels in the
response to the well-intentioned injury of an angioplasty. Every
year, cardiologists perform about half a million of these in the
United States and double that worldwide, threading balloons into
clogged heart arteries to restore blood flow.
Often, though, the freshly opened arteries fill in again with
scar-like growth, a complication that has bedeviled angioplasty
since its invention in 1977. Doctors have tried lasers, cutting
tools, radiation, even gene therapy, to improve results. In the
mid-1990s, they began leaving behind tiny mesh tubes called stents
to prop open the arteries.
Some of these help, but nothing solved the problem completely.
The arteries still narrow up again about 20 percent of the time.
This history of failure helps explain why doctors are so
astonished by what they heard in September at a European cardiology
meeting: Testing showed a new kind of stent, coated with
growth-stopping medicine, is totally effective. Not a single artery
closed up after angioplasty.
"It was too good to believe," says Dr. John LaSala of
Barnes-Jewish Hospital in St. Louis. "Nothing in medicine works
100 percent of the time."
And yet, as far as doctors can tell, this one nearly does.
Reports on three other companies' stents, similar but coated with
different drugs, soon followed. In all, about 700 patients have
been studied. The results are remarkably consistent with almost no
"It's an enormous breakthrough," says Dr. David Faxon of the
University of Chicago, president or the American Heart Association (news - web sites).
"This is the Holy Grail for interventional cardiology."
If no complications emerge, the stents could be on the market
next year. Faxon says they could increase angioplasties by 20
percent to 30 percent, because doctors will use them in arteries
considered too risky before. These include buildups in especially
tiny vessels, ones that are long or diffusely clogged and bad
arteries in diabetics.
The new stents were overshadowed by a more dramatic development
in cardiology - the first artificial heart since the Jarvik-7 in
the 1980s. By the end of November, doctors at four hospitals had
installed Abiomed's self-contained, fully implanted heart in six
men. One did not survive the operation, and two others died later.
Nevertheless, the heart itself appeared to work flawlessly, and
the first patient survived nearly five months - far longer than his
physicians had expected. Doctors said the artificial heart offers a
chance of survival for terminally ill people with congestive heart
failure who do not qualify for transplanted hearts, which are in
In cancer research, the biggest news of the year was Gleevec, a
new drug effective against an unusual digestive cancer called
gastrointestinal stromal tumors. It is also being tested in lung,
prostate and brain cancer.
Standard chemotherapy goes after all fast-dividing cells and
kills them indiscriminately. But Gleevec follows the new approach
to drug design. It is aimed specifically at a protein unique to
cancer, blocking it without harming other parts of the body.
"The importance of it is far more than the drug itself," says
Dr. Harmon Eyre, research director of the American Cancer Society (news - web sites).
"It really is a proof of principle."
Some of the biggest news of the year involved developments that
may be years away from practical use but lay the groundwork for
future breakthroughs. In February, scientists published their first
examination of nearly all the human genetic code. The next task
will be learning what all these genes do. The answers will likely
hold clues for treating many diseases.
Another field in its infancy is the study of stem cells, the
primordial mother cells that give rise to all the body parts.
Scientists believe these cells could be used to replace or fix
Growing these cells, however, requires the death of a human
embryo. In August, President Bush (news - web sites) said his administration will pay
for this research but limit funding to work on self-perpetuating
colonies of stem cells that already existed, not new ones.
For the first time in decades, doctors had to deal with anthrax,
spread now through the mail by terrorists. Although five died,
modern antibiotics and hospital care often proved effective against
the dangerous inhaled form of the disease. The affair also left a
mystery: How did two older women in Manhattan and rural Connecticut
catch the bacteria?
Another development in infectious disease, however, is likely to
affect far more people. In November, the Food and Drug
Administration (news - web sites) approved the sale of Xigris, the first drug ever for
bloodstream bacterial infections, which kill 225,000 people in the
United States annually. The drug works by curbing inflammation and
clotting, the out-of-control processes that make these infections
For doctors treating diabetes, a major development was proof at
last of what many have long suspected: Exercise and weight loss can
lower the risk. A study found that walking and losing 15 pounds
helped people at high risk to cut their chance of getting the
disease in half.
"This is a major advance," says Dr. Christopher Saudek of
Johns Hopkins University, president of the American Diabetes
Association. "It had never been proven that a diet and exercise
program can have enough effect over a four-year period to actually
reduce the risk of new diabetes."
For those who already have the disease, researchers made
progress toward developing sensors that continuously measure
glucose levels in the bloodstream. Researchers hope eventually to
tie this to an implanted insulin pump that will release the hormone
in precise response to the body's needs, just as the pancreas does.
Medical Editor Daniel Q. Haney is a special correspondent for
The Associated Press.
On the Net:
Stent maker: http://www.cordis.com
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