Interventional Lipidology

The Two Approaches: Interventional Cardiology and Interventional Lipidology

1 to 10 Years Before a Heart Attack

There are many plaques present inside the coronary arteries before someone has a heart attack. Plaques can be found as early as in the 20’s and 30’s especially for men. They grow silently for years, even decades, giving no hint of their presence.

Without medical treatment, a plaque can grow and severely obstruct an artery causing angina. In some cases, the severely blocked artery may need to be forcefully opened and a stent placed to keep it open. This is an invasive procedure done in the cath lab.  This is the interventional approach. 

Interventional Cardiology

Preventive Cardiology is a non-invasive medical approach in treating not just one but all plaques in the body - both in the heart and in the brain. A preventive cardiologist identifies patients with plaques earlier and uses evidence-based medical treatment to stop and even reverse the disease.

Preventive Cardiology

Optimal medical treatment, while not invasive, is a potent approach. The COURAGE trial demonstrated in 2007 that prophylactic stenting in stable CHD patients even those with severe blockages, offered no additional benefits over optimal medical therapy alone. More recently, in patients having a major heart attack called STEMI, faster heart attack care with shorter door-to-balloon time to open the blocked artery more quickly did not save more lives.

The images below show plaque regression after just three years of optimal medical therapy.

MRI Plaque Regression
Stop Both Heart Attack and Stroke

A stent treats only one plaque but optimal medical therapy treats all the plaques at the same time.

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