Can 'Good' Cholesterol Zap Heart Disease?

April 15, 2004 -- Three years ago, John Pierce was a 47-year-old year old father of six, seemingly in good health. But one day while he was home alone with the children, Pierce experienced some strange sensations.

"I felt shortness of breath — tightness and — I'm a very active person, so I thought something was wrong," Pierce said.

He managed to get his kids to day care before taking himself to the emergency room, where the doctor gave him the bad news.

"Next thing you know, 'Well, John, you got a 100 percent blockage in one artery and quite a bit of blockage in the other arteries,' " Pierce recalled.

An Experimental Study

The hot topic in heart disease these days is what to do about so-called killer plaques, the collections of fat and inflammation that hide in the walls of our coronary arteries without symptoms until they suddenly burst open and block the flow of blood to heart muscles.

Despite undergoing angioplasty and being treated with cholesterol-lowering medication, Pierce continued to experience chest pains and low energy. Both of Pierce's parents had suffered heart attacks, and now with his own heart problems, it was no surprise that the stay-at-home dad eagerly enrolled in an experimental study to raise so-called good cholesterol

"I said, 'Why sure,' " Pierce said. "'You know, I've got four beautiful boys and whatever I can do for it down the road. Hopefully we can get this worked out.' "

For five weeks, Pierce received a weekly intravenous infusion of a new synthetic form of high-density lipoprotein, also called HDL or good cholesterol. About one-third to one-fourth of blood cholesterol is carried by HDL, which is known as the good cholesterol because a high level of it seems to protect against heart attack.

The study was designed by Dr. Steven Nissen of the Cleveland Clinic. The results, he said, were astonishing.

"The data arrived on my desk about the middle of 2003," Nissen said. "And I looked at it. And I was speechless." This study showed something medical science didn't think was possible. The heart disease was actually reversing itself, so quickly, in fact, that killer plaques were shrinking within a matter of weeks.

Shrinking Plaque

The change was visible in Pierce's ultrasound images, which showed that the plaque had visibly shrunk.

"Before treatment there's a very large fatty plaque here," Nissen pointed out in the ultrasound." And then six weeks later it's about 25 percent smaller in actual area. We've tended to think of the disease as changing only very slowly and to see an effect in only five or six weeks was really quite surprising."

The results have opened the door to a new era in treating coronary artery disease. Now that Pierce has had a taste of the new medicine, he feels that he has a chance to turn back the clock on his heart disease.

"I can get good cleansing breaths. I feel strong enough I can carry my baby around the house quite a bit," Pierce said. "I definitely feel a lot better that I did before. I have a lot of children. I want to live another 40 or 50 years."