Archives for: April 2015

Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology)

by Caldwell B. Esselstyn, Jr., MD

THE AMERICAN JOURNAL OF CARDIOLOGY VOL. 84 , August 1, 1999

“Modern cardiology has given up on curing heart disease. Its aggressive interventions— coronary artery bypass graft, atherectomy, angioplasty, and stenting—do not reduce the frequency of new heart attacks or prolong survival except in small subsets of patients.1 For most patients these procedures do not treat life-threatening plaques.1,2 Thus, it is clear that the goal of cardiology has become the relief of pain and unpleasant symptoms in the face of progressive disability and often death from disease. It is time to call this approach by its true name: palliative cardiology. It is also time to acknowledge that this approach is not the only alternative for our patients.”

1. Forrester JS, Shah PK. Lipid lowering versus revascularization—an idea whose time for testing has come. Circulation 1997;96:1360–1362.

2. Ambrose JA, Fuster V. Can we predict future coronary events in patients with stable coronary artery disease? JAMA 1997;277:343–344.

Read here this landmark cardiology article

Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition

by Caldwell B. Esselstyn Jr. MD

Preventive Cardiology

Volume 4, Issue 4, pages 171–177, Fall 2001

Probably the most important medical article published in the last thirty years.

Of remarkable impact is the Summary:

SUMMARY

The present device-driven, risk factor-identification, rear-guard strategy diagnoses disease after the fact and offers no promise of preventing disease or controlling its progression. We are fortunate to possess the knowledge of how to prevent, arrest, and selectively reverse this disease. However, we are not fortunate in the capacity of our institutions to share this information with the public. The collective conscience and will of our profession is being tested as never before. Ties to industry and politics result in conflict within our private and governmental health institutions, compromising the accuracy of their public message. This is in total violation of the moral imperative of our profession. Now is the time for us to have the courage for legendary work. Science—not the messenger— must dictate the recommendations.

Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?

by Caldwell B. Esselstyn, Jr., MD

in Am J Cardiol. 2010 Sep 15;106(6):902-4.

Access the article here

Dr Esselstyn concludes:

“The time is long overdue for legendary work. We can hardly be proud of a drug and interventional therapy that results in death, morbidity, inordinate expense, and disease progression and can never halt this food-borne epidemic. Every patient with this disease should be made aware of this safe, simple, enduring option to cure himself or herself. Most coronary disease need never exist, and where it does exist, it need not progress. Present coronary artery disease therapy need not become the radical mastectomy of this century”

Informed Strategies for Treating Coronary Disease

“More than 1 million stents are implanted annually in the United States to treat coronary disease, in the continuing hope that they are more effective than medical therapy in preventing heart attacks and prolonging life, despite abundant evidence to the contrary. Despite the highly publicized COURAGE findings, fewer than half of Americans with stable CAD who undergo stent placement have received medical therapy first. This latest meta-analysis, looking at recent PCI trials, again finds no benefit of PCI compared with medical therapy. Increasing use of American College of Cardiology Appropriate Use Criteria and realigning incentives for evidence-based approach will help improve quality of care. A “PCI first” strategy for patients with stable CAD gets a Less Is More designation because there is no known benefit and there are definite harms.”

Rita F. Redberg, MD, MSc, Editor
Arch Intern Med. 2012;172(4):321

This is the commnet of Rita F. Redberg, MD, MSc, Editor of Archives of Internal Medicine, about the article “Coronary Stent Implantation With Initial Medical Therapy Alone vs. Medical Therapy for Stable Coronary Artery Disease” published in Vol 172 No. 4, February 27, 2012.
Archives of Internal Medicine is not just a provincial newspaper. Archives of Internal Medicine is one of the most prestigious journals of Internal Medicine in the world (impact factor in 2010 of 10.64).
Cardiologists (clinical and invasive) from around the world will continue to ignore these evidencies?