Clinical studies are vital tool in treating heart disease

New studies are changing the way that physicians and researchers look at heart disease — the No 1 killer in the Western world. And fewer people are dying of it than ever before.

The reason is clinical studies.

Advances in heart disease treatment and research are the topic of today's Deseret Morning News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Dr. Joseph "Brent" Muhlestein, director of cardiac research at LDS Hospital, and Heidi Thomas, cardiac research coordinator, will take called-in questions on the topic. All calls are confidential.

"Studies are exciting because they're the only way we know to find out things," said Muhlestein. "We learn more about heart disease. And once we come up with an idea that might help somebody, we don't know if it works until we do a study to find out. People get better on their own lots of times so we can never really tell for sure unless we do a study."

Doctors know more about treating heart disease than they do about many disease processes. The reason is simple: There are a lot of heart-related studies going on.

"When someone comes into the hospital, I'm not guessing what to do with them. That's only because patients before them enrolled in a trial. While they understand there's some risk, a patient is monitored much more carefully when in a trial than when he just comes to the clinic. Some studies have shown that people who enroll in a trial do better than people with the same disease who get normal care," even if they're given the placebo instead of the treatment being tested, he said. The difference is likely that extra care.

Patients in trials are also never kept from getting known effective therapy. Instead, a clinical trial is usually an "add-on" to standard treatment, Muhlestein said.

One study questions whether controlling lipid factors like cholesterol and triglyceride levels could prevent the nearly inevitable development of heart disease in people with diabetes. Thomas said that people with diabetes are up to four times as likely to develop heart disease as others. The main predictor is abnormal lipid values.

LDS Hospital is also sponsoring a trial testing the antiplatelet drug clopidogrel in combination with aspirin to block platelet activity.

Clopidogrel has proven effective in preventing clotting in stents, Muhlestein said. Another study has shown it reduces the risk of having a future heart attack after unstable angina.