The Top 10 Medical Advances of the Decade

Heart attacks, called infarcts, were "big" and the damage to the heart muscle often was catastrophic, leading eventually to heart failure and death.

By contrast, treating a heart attack now is all about speed: Speed the patient to the hospital so that a clot that blocks the life-saving flow of blood can be "busted" with drugs like the genetically engineered tissue plasminogen activator or tPA.



Or, if the problem is a vessel narrowed by buildup of plaque, a tiny flexible tube called a stent can be guided from an artery in the groin or the forearm up into the heart, where it is used to prop open the vessel to allow blood to flow normally.

Still other patients are sent to surgery, where surgeons have learned sophisticated techniques to sew new vessels into the heart to bypass diseased arteries.

Moreover, drugs that didn't exist 25 years ago -- chiefly statins like Simvastatin, Lipitor, Mevacor and Crestor -- now are used routinely to slow the progression of atherosclerosis, the medical term that describes the build-up of the hard, waxy substance called plaque that narrows arteries.

Cardiologists say such efforts really began to bear fruit after 2000.

"In 1998/2000, the American Heart Association set a decade-long goal to reduce coronary heart disease and stroke and risk by 25 percent by 2010. We actually realized this goal by 2008 and have seen continued improvements in the reduction of deaths due to coronary heart disease and stroke," said Dr. Clyde Yancy, president of the American Heart Association. "As of today we have seen a near 40 percent reduction in death due to coronary artery disease since 1998/2000."

Research shows about half of the gains in heart disease came from new treatment interventions, Yancy said, and the other half, or up to 60 percent, are because of prevention.

"What this means is that the community 'gets it'. Better control of blood pressure, pre-emptive lowering of blood cholesterol levels, better diets, and reduced smoking are resulting in fewer [cardiac] events," he said.

5. Stem Cell Research: Laboratory Breakthroughs and Some Clinical Advances

Probably no area of research has fired the public imagination and ignited the fires of public controversy as much as stem cell research.

In reality, this area has generated more political action than reproducible clinical advances -- the much-publicized ban on federal funding of embryonic stem cell research was rescinded this year.



But the clinical advances -- even when they have come from pilot studies --have been tantalizing.

For example, European researchers genetically manipulated bone marrow cells taken from two 7-year-old boys and then transplanted the altered cells back into the boys and apparently arrested the progress of a fatal brain disease called adrenoleukodystropy or ALD, which was the disease that affected the child in the movie "Lorenzo's Oil".

"Cases like those fuel the promise of stem cell research. As the population ages, the opportunity for 'replacement parts' becomes more and more inviting, and I'm counting on stem cell research to give me, at least, new cartilage for my knees," Humphreys joked. "This seems likely to be the future of regenerative medicine."

Stem cell researcher Dr. George Daley of Children's Hospital Boston, called the progress in both adult and embryonic stem cell research this decade "breathtaking."

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