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Dr. Andrew Rynne

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Suggest treatmemt for coronary artery disease

Answered by
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Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

Question
Are any drugs available that can be prescribed which can reverse coronary artery disease, as opposed to prevent, or delay its progression ?
In particular, am referring to narrowing of the arteries, plaques, clots, and blockages.
Some seem plausible such as Plavix, Resveratrol, Niacin (around 100 mg), aspirin, Green Tea leaf extract, Omega-3 Fish Oil, or Coumadin.

But nothing seems definitively effective or clinically accepted. Can it really be that difficult to develop a drug to dissolve these blockages quickly, or slowly ? Is anything else available ?
Tue, 5 Aug 2014 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 3 hours later
Brief Answer:
Please see below.

Detailed Answer:
Dear Sir
Plavix, coumadin, aspirin are anti-clot forming drugs. The prevent formation of clot on already existing plaque, thus prevent total or near-total occlusion (which lead to heart attack). However these drugs do not cause regression of already existing atherosclerotic plaque.
Lipid lowering drugs (statin especially atorva and rosuva) have been found to reduce plaque burden in coronary arteries as well as some other places in arterial system. This has been directly seen. However the extent of reduction is not very impressive. However this definitely leads to reduction in number of acute events and increase in time to first event.
Chelating agents and some anti-oxidants were tried for reduction of plaques but not found to be effective.
One more important thing, coronary artery disease in not all about plaque and obstruction. There is more to it. The formation of clot over plaque, the response of muscle to stoppage of blood flow, the different effects of similar looking plaques are some aspects of coronary artery disease which are important but poorly understood.
Sincerely
Sukhvinder
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