Cardiovascular Therapeutics - Applications of Biotechnology in Cardiovascular Therapeutics - page 2

Table 1.1 Landmarks in the historical evolution of cardiovascular therapy

Year Landmark

1785 William Withering discovered foxglove; its extract digitalis became a mainstay for

treatment of CHF

1847 Invention of glyceryl trinitrate by Ascanio Sobrero in Italy and demonstration of

headache and other systemic effects after its administration by sublingual route
(Marsh and Marsh 2000 )

1876 Introduction of glyceryl trinitrate for the treatment of angina pectoris (Murrell 1879 )

1881 Invention of a device to measure blood pressure by Samuel Siegfried Karl Ritter

von Basch of Austria

1929 Start of the modern era of cardiac catheterization: Werner Forssmann's dramatic

right-heart self-catheterization in an effort to find ways to inject drugs into the
heart for cardiac resuscitation

1960 Coronary artery bypass graft procedure introduced

1960 First description of myocardial ischemia-reperfusion injury (Jennings et al. 1960 )

1970 Percutaneous transluminal coronary angioplasty procedure introduced

1974 Concept of image-guided catheter-directed thrombolysis as an alternative method to

systemic intravenous infusion (Dotter et al. 1974 )

1980s Invention of the first stent by Julio Palmaz

1985 First proposal for cell therapy of cardiovascular disorders: myocyte transplantation

for treatment of complete heart block (Sade and Fitzharris 1985 )

1989 Pulsed-spray pharmacomechanical thrombolysis (Bookstein et al. 1989 )

1990 Introduction of the drug-eluting stents

1995 Gene therapy for cardiovascular disease: first clinical trial of familial

hypercholesterolemia using ex vivo hepatic low-density lipoprotein receptor
gene transfer via a retroviral vector

2000 Local drug delivery by regional myocardial infiltration by the percutaneous coronary

venous route demonstrated in experimental animals (Herity et al. 2000 )

2000 Introduction of induced angiogenesis therapy for myocardial ischemic disease

2002 Transplantation of hematopoietic stem cells into patients for treatment of ischemic

heart disease

Overview of Cardiovascular Disease

Epidemiology of Cardiovascular Disease

Cardiovascular disease (CVD) has remained the leading cause of death worldwide
despite the tremendous progress made in medical and surgical treatment for this
disease. In the USA, approximately 70 million persons have symptoms or findings
(without symptoms) pertaining to coronary artery disease (CAD); of these patients,
10% have clinically confirmed disease. Not all of these patients have coronary
artery disease, as some may have only angina pectoris but no demonstrable pathol-
ogy in the coronary arteries. On the other hand, there are patients with coronary
artery disease who may not have any investigations or require hospitalization.
Sometimes it is postmortem finding in patients who die of other causes. The inci-
dence is 1 million myocardial infarctions per year and 700,000 coronary-related
deaths per year in the USA. Nearly 8 million Americans alive today have suffered