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Second Heart Attack Not Always Tied to Original Blockage
Date:1/19/2011

said. "Now the question is, is there anything we can do to prevent them from becoming symptomatic in the future?"

The study is reported in the Jan. 20 issue of the New England Journal of Medicine.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said he thought the research was well-done and that it confirms prior studies that identified lesions that went on to cause successive cardiac events.

The message of the study, Fonarow said, is that heart disease needs to be treated systemically with diet, exercise and medication, in addition to treating detectable blockages.

"Just because you have a normal stress test doesn't mean you're out of the woods. Fundamental treatment needs to focus on treating the underlying disease," Fonarow said.

"There's no question treating the culprit lesion is critical," he added. "Even in these patients with known disease, there are further opportunities to improve their condition. There are many other lesions that don't show up on the angiogram . . . that are definitely amenable to the cardiovascular protection of [lifestyle and medication]."

More information

Visit the American Heart Association for more on heart attacks.

SOURCES: Gregg W. Stone, M.D., director, cardiovascular research and education, New York-Presbyterian Hospital/Columbia University Medical Center, New York City; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Jan. 20, 2011, New England Journal of Medicine


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