NEW HOPE FOR A HEART AILMENTS

NEW HOPE FOR A HEALTHY HEART

A miracle pill that repairs tissue damage of a heart attack and a cheek swab that assesses the impact of statins on your body are just two developments likely to improve the prognosis for those at risk of heart disease…
Wednesday 22 June 2011 1:40 PM IST

IMAGINE popping a pill that could repair the damage suffered by your heart after an attack. Or even halt a heart attack in its early stages. You may have to wait a decade for this development, but rest assured that it’s on its way.

British scientists have found a means of repairing cells damaged during a heart attack in mice, leading to expectations that a pill capable to perform this repair in humans would be available in ten years. This breakthrough discovery has created hope for millions of people at high risk of heart attack. Experts predict this would take the form of a preventative drug for people at high risk and may even be effective for people in the early stages of a heart attack.

"The pill to mend a damaged heart sounds like science fiction but might a possibility in a decade,” says Dr Neeraj Bhalla, chairman and HoD, cardiology, BL Kapur Memorial Hospital.

"In the past, several attempts were made but they never worked out. Now, scientists are working on a pill which will directly stimulate the stem cells in the heart and convert them into health muscle cells, which will aid in repairing the damaged heart,” he adds.

Currently, any damage caused during a heart attack is permanent. Though more people survive attacks than in the past due to more effective medication, the damage to the heart is irreversible.

GRIM SCENARIO

NEWS about this pill is welcome in India, especially as the outlook for heart disease among urban Indians bleak. Indians accounted for 60 per cent of the world’s heart disease load 2010, and this figure is slated to rise. Findings of a seven- year study conducted among 1,100 young adults in New Delhi confirm this.

The study, published in the Journal the American College of Cardiology , found that all the risk parameters for cardiac disease including — hypertension, obesity and diabetes rose in this group over the time of study. Such a remarkable rise suggests that young adults in India could have high rates of heart disease and stroke. No wonder, the need to expedite preventive measures of heart risks is being felt like never before.

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MAGIC HEART PILL

COMBINATION of low- dose aspirin, statins and two blood pressure- lowering medicines, the polypill has been promoted as an effective means of reducing the risk heart attacks, strokes and other cardiovascular problems across the world. It was first proposed the British Medical Journal eight years ago and has now moved out of labs to the chemists’ stores.

Short- term trials of polypill have shown that it’s as effective as its individual components – aspirin, statin, beta blocker and ACE inhibitor. The one- a- day pill is touted to cut the risk factors for heart diseases.

However, outcome studies are still awaited, which will show how successful is polypill in preventing heart diseases,” says Dr Bhalla.

The good news is that it’s now available in India too, courtesy Cipla and Cadilla. Dr Reddy’s has joined the fray as it’s likely to launch its ‘ Red heart pill’ soon.

Its research wing began work on the ‘ Red heart pill’ ( as it is has been called) in 2005. An international trial of Dr Reddy's four- inone combination pill has found it can cut the risk of heart disease and stroke by 50 per cent with everyday use. It was also concluded that those with a higher risk of heart disease will be able to get greater benefits from the pill, to the tune of 80 per cent.

But experts say that the pill may not be suitable for everyone so every patient should be assessed and treated on an individual basis. More research is needed to clear the doubts that still exist about it.

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DNA TEST FOR STATINS

ANOTHER development creating a stir among experts is a DNA analysis that can foretell the side effects of statins before you start using them. Statins, as we know, are the most prescribed drugs in the world for reducing cholesterol levels and cutting the chances of a heart attack. On the flip side, they come with certain side effects such as muscle pain and weakness.

About 20 per cent of those who take the drugs often complain of these and the FDA recently issued a warning against a specific statin, Zocor,

DRUGS FOR DAMAGED HEART

ALTHOUGH prevention is being touted as the first step in improving cardiac health, studies are also being directed on finding ways of reducing the damage done to the heart during an attack. A new anti- clotting drug, Ticagrelor, could cut one in five deaths following a heart attack. This finding by the University of Sheffield comes in the wake of cardiologists’ claims that in the last one year, many deaths of patients following a heart attack were largely avoidable.

Anti- clotting drugs have been available for ages but this new one, Ticagrelor, comes with a fillip and is 20 per cent more effective than the older one, Clopidogrel.

What’s more, Ticagrelor works as well on those above 75 years as on younger patients.

However, there are concerns about the cost of the newly licensed drug. It is almost ten times the cost of Clopidogrel. It could also have some serious side effects like shortness of breathing, bleeding and skin allergies.

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BIO-ABSORBABLE STENTS

WHILE the wait for Ticagrelor continues in India, those with cardiac problems can rejoice over bio- absorbable stents that have found their way into the country. Recommended for dilating blocked arteries, metallic stents have been in use for a long period. Arterial blockage has various causes. At times age, chronic diseases, or congenital factors make artery walls weak, causing them to recoil and narrow.

In such cases stents help with dilatation. “ Metallic stents are known to cause infections, recurrence of blockages in the same area or clot formations in the long run,” says Dr Viveka Kumar, senior consultant, interventional cardiology and electrophysiologist, Max Healthcare. In extreme cases a tumour may also develop due to long term presence of the device.

Though medicated stents developed a decade ago have fewer side- effects, they are still not absolutely safe. "Those on stents – whether medicated or non- medicated are supposed to be on blood thinners for the rest of their lives. This makes it difficult for them to undergo surgeries or any medical procedure involving heavy bleeding later in their lives,” says Dr Kumar.

Now, stents made of bioabsorbable materials are being used. Although they are in trail phase currently, large scale commercial usage is likely to begin in a year. “ Unlike the metallic stents, these new stents don’t stay within the artery forever.

Rather, they provide support to the dilated artery walls for a few months and then gradually dissolve in a year,” says Dr Atul Mathur, director, interventional cardiology, Fortis Escorts Hospital.

This naturally chucks the need for blood thinners and also the risks of side effects.