Thursday, August 24, 2017 8:41:14 AM
Does this mean that Vascepa will be an automatic success in lowering CAD - hardly - from what I recall a recent study on PCSK9-s revealed that the reduction of atherosclerosis was not what was expected for the reduction in LDL . Look at NIacin it raises HDL and HDL was touted as being one of the strongest markers for CAD - no effect on CAD - Zetia initially shown to have no effect on CAD after reducing LDL - repeat study suggested mild benefit .... which of course gets into the whole issue of outcomes studies vs just looking at markers the role of inflammation in CAD etc etc
After practicing medicine for many years one point becomes clear - biological systems are immensely complex - controlling and isolating factors to determine cause and effect is extremely difficult. Whereas , in the electronic, mechanical perhaps even chemical world this is rather easy.
Absence or variation of a gene, resulting in variation in a marker chemical, may not necessarily be the direct correlation we believe it is for disease induction. That gene alteration may be having countless other effects that we are unable to identify - IN many ways we are the blind man who can only feel one part of the elephant - then run out insisting that the elephant is a snake because the only part we felt was the trunk. (Unfortunately, the guy upstairs who made us - never gave us the blueprints).
So this study is great news and perhaps it will lead to the development of a med that has success in lowering the incidence of CAD. However, let me perhaps reflect onto your own experience. WHen you hear about a great breakthrough for cancer - what do you think ?
Currently , I am very jaundiced about such claims - I have heard them for over 30 years. Perhaps there are great breakthroughs in our knowledge and understanding - yet the reality is - cancer has become the #1 killer and our progress is painfully slow as compared to CAD. ( OF course CAD was mainly a plumbing problem - open the pipes - Cancer is so much more complex)
The proof is in the pudding ...and the pudding is still in the oven .......
(dictated with Dragon Dictate excuse errors)
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