Thomas Fogarty, MD, a pioneer in the field of less-invasive surgery and the development of various cardiovascular breakthroughs, has been awarded $500,000 from the Lemelson-MIT Program (New York), granted in recognition of his 40 years of groundbreaking work in medicine. The program calls the prize "the world's largest single award for invention and innovation," saying that the devices invented by Fogarty "have saved millions of lives and limbs, developed innovative, vital clinical procedures, founded important medical device firms and trained countless young surgeons, engineers and scientists."

Fogarty holds 63 U.S. patents in surgical devices, with additional patents pending. His landmark invention, the Fogarty Embolectomy Catheter, was introduced in 1963 as the world's first balloon catheter. It marked the beginning of less-invasive surgery and was a preamble device that led to the development of the world's first balloon catheter for angioplasty in 1965.

A recent Fogarty invention is the Aortic Stent-Graft, a device that enables minimally-invasive treatment of patients with aneurysms who cannot withstand the trauma of major abdominal surgery. Other Fogarty inventions include Fogarty Surgical Clips and Clamps, which have become standards of care for vascular surgeons to temporarily occlude vessels during surgery, and the Hancock Tissue Heart Valve, the world's first porcine valve, which Fogarty invented with Warren Hancock.

"Invention is rewarding if done properly and for the right reasons," Fogarty said. "I've achieved the things I've done by asking one question: 'Can it be done better?' I've tried to improve the application of technology to daily patient care." He is founder or co-founder of more than 25 start-up companies developing innovative products for the medical/surgical marketplace. In 1980, he established Fogarty Engineering to design and develop ideas for new medical devices. Together with colleagues Mark Wan and Wilf Jaeger, Fogarty co-founded Three Arch Partners, a venture capital fund created to further technological innovation.

The Lemelson-MIT Prize is awarded annually to a living American inventor-innovator who has significantly contributed to society through invention and who has shown a commitment to stimulating invention and creativity in the U.S.

Hostility linked to atherosclerosis

The Journal of the American Medical Association (JAMA) published a paper in the May 17, 2000, issue by Dr. Carlos Iribarren, MD, and Stephen Sidney, MD, affiliates of Kaiser Permanente, and co-authors, linking hostility in early adulthood to later development of coronary artery calcification, or atherosclerosis. Part of the Coronary Artery Risk Development in Young Adults (CARDIA) study, the research was launched in 1985 with funding from the National Heart, Lung and Blood Institute (Bethesda, Maryland).

The CARDIA study used as a key marker the measurements of coronary artery calcification obtained via the Electron Beam Tomography (EBT) system made by Imatron (South San Francisco, California). The measurements compared two alternate indices for the assessment of hostility in a 374-subject subgroup of the 5,115-patient CARDIA study. It was designed to determine whether these calcification measurements were independent of established risk factors for coronary artery disease (CAD), eliminating the biases caused by using clinical end points for CAD – hence the use of EBT as the definitive marker for subclinical atherosclerosis.

The authors reported that the assessments of hostility, made five and 10 years prior to the EBT study, correlated with the development of coronary artery calcification using a very precise scanning and scoring protocol. Despite insufficient sampling numbers to identify race and gender trends, the association between "hostility and coronary artery calcification held constant after correction for demographic, lifestyle, and physiological variables," according to the study.

Older Americans shorted on statin therapy

More than half of older Americans diagnosed with elevated cholesterol did not receive the statin therapy that is widely recognized as the most effective treatment for this potentially life-threatening condition, reports a new study from the Alliance for Aging Research (AAR; Washington). The AAR study indicates serious under-treatment of many older Americans compared to federal benchmarks. The U.S. Department of Health and Human Services program, Healthy People 2000, recommends that at least 75% of patients diagnosed with high cholesterol should receive diet and drug therapy, compared to the 45% shown in the study.

Underwritten with an educational grant from Bayer (Pittsburgh, Pennsylvania), the study also found that only 20% of older Americans with heart disease were prescribed treatments for lowering their cholesterol levels. Statins, the agents given to more than 85% of cholesterol patients who do receive drug treatment, have been proven highly effective in lowering low-density lipoprotein (LDL), the most dangerous form of cholesterol.

These findings are disturbing since older Americans are the fastest growing portion of the population and have the highest rate of coronary diseases, which are directly related to cholesterol levels. "This is a clear example of too many older Americans being inadequately served in the health care arena," said Daniel Perry, executive director of the AAR. "Cardiovascular disease will cause more deaths than any other condition. Health care for older people should aggressively aim to lower their risk of heart attack and stroke."

The results stem from a national four-year retrospective study of 75,000 office-based physician visits conducted by the research group Project HOPE on behalf of the Alliance for Aging Research. A second, companion, study funded by the AAR was conducted among 1,000 elderly post-heart attack patients and 250 physicians and focused on cholesterol awareness, post-heart attack experience and treatment practices.

Geriatrician William Hazzard, MD, of the University of Washington School of Medicine (Seattle, Washington), said a revision of medical guidelines "would help ensure that physicians actually prescribe these much needed therapies to high-risk patient populations." Eighty-eight percent of physicians surveyed about older patients at risk to cardiovascular diseases stated they would welcome more clinical evidence to support use of statins in the elderly, as well as clearer guidelines in treatment of this patient population. Founded to promote medical research into human aging, AAR is a citizen advocacy group targeting the improvement of older Americans' health and independence.

Dialysis linked to artery calcification in young

Nearly 90% of young adults undergoing dialysis may show signs of coronary artery calcification, according to a study published in the May 18 issue of the New England Journal of Medicine. Additionally, in most patients, the amount of calcification doubled within two years. The authors, researchers at UCLA (Los Angeles, California), said they were surprised by the results in such a young age group. Virtually unheard of in healthy men and women between the ages of 20 and 30, the condition occurs in only 10% of women and 25% of men between the ages of 40 and 49 years. The new research showed that all study patients with coronary artery calcification ingested nearly twice as much calcium through phosphate-binding agents, had higher serum phosphorus levels and had higher calcium-phosphorusion products in their bloodstream, compared to patients without signs of calcification.

"This is the first study to show the extent of this particular form of cardiovascular abnormality in younger patients on long-term dialysis," said UCLA pediatric nephrologist Isidro Salusky, MD, the senior author. "Based on radiographic evidence, we are concerned that many young adults with end-stage renal disease have clinically silent, but potentially serious, coronary artery lesions." And William Goodman, MD, of UCLA's School of Medicine, said that the study indicates that doctors treating dialysis patients "may want to reconsider the use of large doses of calcium-containing medications in patients who are treated with dialysis." Researchers used electron beam computed tomography to develop the data, with repeat EBCT scans taken in a subset of patients after 18 to 24 months.

Venom helpful in reducing stroke damage

A report in the May 9, 2000, issue of USA Today's online HealthScout hails the ancient symbol of medicine, the serpent, as a possible savior for stroke victims. If researchers are correct, venom from the Malaysian pit viper could be used to prevent or reduce the damage caused by stroke, including paralysis and loss of the ability to communicate, eat, dress, climb stairs, and use the toilet independently.

The study that yielded these findings was conducted from 1993-1998, and included 500 stroke victims. Roughly half of the participants received the venomous concoction called ancrod; the remaining half received traditional stroke treatments plus a placebo. Scientists found that about 42% of the patients in the ancrod group returned to independent functioning, vs. only 34% of the placebo group. The results were not overly dramatic, reports USA Today; however, the news gives stroke victims hope for a future treatment alternative. Currently, the only FDA-approved drug for stroke treatment is the clot buster tPA. Each year, more than 500,000 Americans suffer blockages caused by clots, called ischemic strokes. The full results of the study appear in the May 10, 2000, issue of the Journal of the American Medical Association.

Restenosis drug successful in animal trial

Scientists at the Parker Hughes Institute (Saint Paul, Minnesota) report that they have developed a drug, named EGF-Genistein, that prevents restenosis following angioplasty, with the results published in the Journal of Cardiovascular Pharmacology.

The administration of EGF-Genistein was shown to prevent development of restenosis in more than 75% of the animals tested. The institute has received U.S. patent No. 6,034,053 for the drug, and it is being further developed for clinical use as a non-toxic drug for prevention of restenosis.