The formation, growth and rupture of a cholesterol-filled plaque is the cause of most heart attacks and sudden cardiac deaths.
Atherosclerosis is the disease process that leads to heart attack and stroke. It is the slow, progressive and diffuse process that causes the build up of cholesterol within the wall of the arteries. It is usually a silent process and gives not hint of its presence until it ruptures and within minutes an acute life threatening emergency unfolds. In 1 of 3, it proves fatal.
When the plaque ruptures, time lapse is measured in minutes. But there was plenty to time of identify that the patient was at risk and with appropriate treatment, halt the progression of this deadly process.
With optimal preventive treatment, most heart attacks and strokes are considered largely preventable.
Only 14% of heart attacks involve arteries with advanced plaques causing more that 70% narrowing of the arteries before the heart attack. These patients could have been treated with stents if identified before the heart attack. The rest are not preventable with stents but preventable with optimal medical therapy.
The heart attack in progress is due to plaque rupture and subsequent rapid clot formation converting a mild asymptomatic plaque to total occlusion. This is the cause of most heart attacks and sudden cardiac death.
Data from the American Heart Association shows that about half of all deaths from coronary heart disease are sudden and unexpected, regardless of the underlying disease. Sudden cardiac death is a major health problem, causing about 166,200 deaths each year among U.S. adults before reaching a hospital or emergency room.
The normal course of CHD is one of recurring events. After the first heart attack, most patients become a "heart patient" and can expect to have more recurring problems with their heart - a time measured in months to years.
A large healthcare industry has developed and continues to thrive to cater to these predictable recurring cardiovascular events. Our ability to treat these events have become better and better in the last 40 years. We have now gotten to the point that the treatment of acute events has become so well refined that further improvements is resulting in smaller and smaller incremental gains. Why? Because we are not preventing heart disease, just treating them when they are more advanced.
LDL cholesterol plays the key role in the development, growth and rupture of plaque within the wall of the artery. Rapid advances in medical science in the last decade have revealed how optimal cholesterol treatment can change the characteristics of the plaque itself to slow down progression, prevent rupture and even cause regression.
