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Health Capsules
December 2006
Late Angioplasty After a Heart Attack

Doctors recommend that people who have heart attacks receive treatment to open their blocked arteries within 12 hours after an attack.  Even past those 12 hours, though, a procedure to open blocked arteries called angioplasty was thought to prevent future heart problems.  A new study, however, found that stable patients getting late angioplasty did no better than patients on drug therapy alone.

Each year, about a million people in the U.S. have a heart attack and half of them die.  The NIH-funded Occluded Artery Trial sought to find out whether it really helped stable patients to perform angioplasty 3-28 days after a heart attack in a totally blocked coronary artery related to the heart attack.

A total of 2,166 patients were randomly assigned to receive drug therapy or routine angioplasty with stenting (placing a metal mesh tube in the artery to keep it open) along with drug therapy.  The trial found no significant difference between the groups over an average of 3 years and up to 5.  There was a trend toward more heart attacks in the angioplasty group but it was not statistically significant.  The patients will need to be followed for longer to see if any significant trends emerge.

“These results challenge the long-standing belief that opening a blocked artery is always good,” said NHLBI director Dr. Elizabeth G. Nabel.  The late opening of a coronary artery involved in a heart attack should be reserved only for certain patients, the researchers say, such as those who are unstable or continue to have chest pain after a heart attack.

If you think you’re having a heart attack, this study shows how important it is to seek care as soon as possible.  But don’t forget that controlling the risk factors for heart disease—such as high cholesterol and high blood pressure—is your first line of defense against heart attacks.

Definitions iconDefinitions
Procedure in which a thin tube with a balloon or other device on the end is threaded through a blood vessel to the site of a narrow or blocked artery. The balloon is then inflated to widen the artery and restore the flow of blood.

The tubes that carry blood from the heart throughout the body.

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  Longer Life, for Mice

Resveratrol, a compound found in grapes, wines and nuts, was all over the news recently.  Overweight aged male mice whose high-calorie diet was supplemented with resveratrol were healthier and lived longer than mice eating the same diet without the supplement.  As with many promising compounds researchers have studied in the past, however, it’s best to be cautious about what resveratrol will be able to do for people.

Resveratrol is a small molecule produced by some plants in response to stress.  Studies over the last few years have found that it can extend the lifespan of yeast, worms, flies and fish.  Researchers funded partly by NIH set out to study the compound in mice, which are often used for experiments before testing in people.

The researchers placed year-old mice (considered middle-aged) on three different diets: a standard mouse diet, a high-fat, high-calorie diet and a high-fat, high-calorie diet supplemented with resveratrol.  By 114 weeks (old age for a mouse), 58% of the high-calorie mice had died.  However, only 42% of the mice eating the same high-calorie diet with resveratrol had died, similar to that of the mice eating the standard diet.

Resveratrol didn’t cause a significant reduction in body weight, but it still produced several changes linked with better health and longer life, such as lower blood levels of several factors that, in humans, predict the onset of diabetes.  There weren’t any noticeable toxic effects.

However, it’s important to keep in mind that this is a study of male mice.  We still have much to learn about resveratrol’s safety and effectiveness in humans.

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From NIH’s National Library of Medicine

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