ATHEROTHROMBOSIS:

Are you at risk?

Atherothrombosis. Few people are familiar with the word. And yet atherothrombosis (or 'AT') is the underlying condition ultimately responsible for the greatest number of deaths in Singapore.

AT causes heart attack, stroke, and peripheral artery disease (PAD or leg vessel blockages) - diseases which most people would know of. The risk factors that increase your chance of getting AT are familiar names like high blood pressure, cholesterol, and obesity. AT is the common link between all these diseases and risk factors, and yet this silent killer goes largely unrecognised by the man on the street.

WHAT IS ATHEROTHROMBOSIS?

Atherothrombosis is a global disease. It means that if a person has atherothrombosis affecting their brain (e.g. if they have had a previous stroke), they are also likely to have atherothrombosis affecting their heart and limbs. predisposing them to a heart attack or peripheral artery disease.

AT starts when deposits such as cholesterol build up in the walls of our arteries. Over time these deposits, known as plaques, restrict the flow of oxygen-rich blood throughout the body. This is a gradual process over years. As blood flows over the plaque, stress are exerted on the plaque surface, eventually causing the plaque to rupture.

This acute event causes platelets in the blood to stick to the plaque and to other platelets forming a blood clot. This clot (or 'thrombus') can limit or completely stop the flow of blood to parts of the heart or brain, giving rise to a heart attack, or stroke. That's why it is critical to treat atherothrombosis and reduce the risk of a life-threatening clot forming.

DON'T GET ATTACKED

It is important that we work to raise the awareness of atherothrombosis, particularly among those who have diabetes. Persons with diabetes are at an increased risk of developing atherothrombosis and are therefore also at an increased risk of suffering an atherothrombotic event such as heart attack, stroke or PAD.

Statistics from the Reach Registry - a worldwide survey of AT patients - suggest that on average, around one in eight patients with stable atherothrombosis will die, have a heart attack or stroke, or be hospitalised for a complication arising from atherothrombosis within a year.

Understanding the condition and the risk factors associated with it is the first step towards patients playing an active role in preventing and reducing their risk of AT. If all with diabetes understand that having previously suffered from one manifestation of atherothrombosis (e.g. a heart attack) increases their risk of developing other forms of the disease, they can take steps to prevent and treat atherothrombosis. How many are aware that they can reduce their risk through lifestyle changes and medication?

Only with increased awareness of the prevalence, prevention and treatment of AT - among both the general public and the medical profession - can we begin to take the first steps to win the battle against the silent killer that is atherothrombosis.

Reducing your AT risk
• Regular gentle exercise

• Go for screening
• Eating healthily

• Prevent stress
• Maintain an ideal weight

• Avoid smoking
• Avoid excessive alcohol intake
 

CHARISMA TRIAL
A global clinical vial called CHARISMA. which sought to further explore the efficacy of anti-platelet therapy in preventing atherothrombotic events. has come to an end. CHARISMA stands for 'Clopidogrel for High Atherothrombosis Risk of lschemic Stabilization, Management and Avoidance'.
 

A total of 15,603 patients enrolled in the trial, which focused on both patients with documented atherothrombotic events (such as stroke, heart attack and peripheral artery disease) as well as those with multiple AT risk factors who had not yet suffered an event. The results showed that Clopidogrel (a drug used to treat AT, marketed under the brand name Plavix) caused a significant reduction in clinical events in patients with documented AT events, as a form of secondary prevention. Further details of the trial results will be discussed at an AT symposium in Singapore at the end of April 2006.
 

This article was brought to you by Sanofi.