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Preventing a heart attack

December 01, 2012
Shaista Malik, MD, Cardiologist and director of UCI Healthcare’s Preventive Cardiology Program

The facts are alarming: Almost 50 percent of people who die suddenly from a heart attack had no prior symptoms. Many others with serious cardiovascular risk factors aren’t aware of them—or feel powerless to change long-entrenched habits that weaken their heart.

The Preventive Cardiology Program at UC Irvine Medical Center provides a one-stop location where people concerned about their risk of having a heart attack can be proactive. Staffed by cardiovascular experts, the program is designed to help people keep their hearts healthy—and to catch the so-called heart attack waiting to happen.

“Each year, almost 800,000 Americans have a first heart attack—a majority of which are completely preventable,” says cardiologist Dr. Shaista Malik, who directs the program. “About 29 percent of women and 37 percent of men who die from coronary artery disease —the condition that causes heart attacks—are younger than 55. But if problems are detected and addressed in a timely manner with proper medications, procedures and lifestyle changes, the progression of heart disease can be slowed and sometimes even reversed.”

Designed to catch the heart attacks waiting to happen

The UCI Health Preventive Cardiology Program is for people with or without known cardiovascular disease, who have risk factors such as obesity, high blood pressure, abnormal cholesterol levels, diabetes, a tobacco habit or family history of heart problems.

Screening begins with a thorough medical history, followed by a computerized risk-factor assessment, physical exam, resting EKG, nutritional evaluation and lab tests. The lab work includes an assessment of selected biomarkers—biological molecules that are red flags for certain types of heart problems. The presence of the biomarker troponin, for example, signals heart-cell damage, while evidence of C-reactive protein warns of inflammation—an indicator of plaque deposits in arteries.

Leading-edge screening

State-of-the-art tests and imaging studies further determine patients’ risk for a life-threatening cardiac event. “If testing confirms that the patient is at high risk for a heart attack or related condition, recommendations are made for appropriate treatments and procedures,” says Malik. Screening ranges from treadmill or ultrasound tests to CT scanning for coronary calcification.

“Calcium deposits in coronary arteries are strong predictors of potential heart attacks and cardiac disease,” says Nathan Wong, PhD. He directs the university’s Heart Disease Prevention Program, which focuses on research to identify new risk markers and measures for the early detection of cardiovascular disease.

“Several studies have documented that people with moderate or significant deposits of calcium have a five- to tenfold greater risk of future heart attacks or other heart problems than people with no coronary calcium buildup,” notes Wong. “This places them in a higher risk category, which warrants more intensive treatment.”

Working together

A multidisciplinary team approach is an essential to the Preventive Cardiology Program. Registered dietitian Geeta Sikand and exercise physiologist Stanley Bassin, PhD, work with cardiologists to create a personalized action plan for each patient. The plan includes a nutritional assessment and prescription for physical activity, as well as additional behavioral and clinical steps to lower the risk of a life-threatening cardiac event. Smoking cessation classes, stress reduction and weight-management counseling are available, if needed.

At-risk individuals also are started on such therapies as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta blockers. Patients return for regular follow-up visits with the Preventive Cardiology Program team to review their progress and discuss adjustments in risk-reduction plans and prescriptions.

The Preventive Cardiology Program adheres to the latest guidelines recommended by the American Heart Association and the American College of Cardiology. For an appointment or more information, call 714-456-6699.

Learn more about Dr. Malik ›