Consumer text provides cutting-edge advice for reducing the risk of heart attack. Discusses the warning signs, determine individual risk, and more. Explores the latest advances in heart research.

Dr. Bob Arnot is one of America's premier patient advocates and authorities on medicine. He has served as health correspondent for CBS This Morning, the CBS Evening News with Dan Rather, and chief medical correspondent for The Today Show and Dateline NBC.

Preface In a small village in northern Italy called Limone sul Garda live people with astonishingly little heart disease. Their bodies produce a protein called ApoA-I Milano. This protein appears to be as close to a miracle substance as has even been found in the century-long history of modern cardiology. ApoA-I Milano strikes at the epicenter of heart disease, the soft fatty core of the blockages found in coronary arteries. ApoA-I Milano rapidly mobilizes cholesterol and transports it away, sharply decreasing the size of the blockage. What truly blows researchers away is how quickly ApoA-I Milano works.The conventional wisdom is that it takes many years of rigorous dieting, exercise, and medications even to begin to make a dent in lowering cholesterol. Yet ApoA-I works in as little as forty-eight hours!This has completely revolutionized the thinking of cardiologists like the Cleveland Clinic's Dr. Steven Nissen, who now sees coronary artery disease as a tremendously dynamic condition capable of breathtaking changes in very short periods of time. Just five weekly treatments of ApoA-I Milano, called ETC-216 in its pharmaceutical form, in human beings produced significant regression of coronary artery disease. ApoA-I has been used alone, but already cardiologists are planning to use it with other lifesaving medications such as statins. The future of heart disease therapy may look like that of certain cancers cures -- a cocktail of drugs, each hitting a different target. The up-and-coming heart disease cocktails will cure the disease, say many of the nation's top cardiologists, entirely preventing heart attacks and deaths from heart disease in much of the population -- if begun early enough.New miracle drugs are even more critical to immediate lifesaving efforts. Doctors used to think of coronary artery disease as discrete blockages in the arteries that could be easily seen on coronary angiograms and treated with surgery or balloon therapy. Now a new research device called intravascular ultrasound paints a much more alarming picture. While a single large blockage may be visible on an angiogram, there may be dozens of submerged plaques that show only as small blockages or don't show at all. The ultrasound shows that the submerged plaques are huge. In effect, it's like having the street in front of your house lined with dozens of improvised explosive devices, mines and grenades, any one of which could explode at any moment. You may see one at the end of your driveway, but all the rest are buried.The smartest strategy is to defuse these explosive devices. Diffusing an entire artery can be done only with medication or by completely bypassing it. Fortunately, as you'll read in the chapter on medications, this can be done quickly and effectively.The most stunning development in the long history of cardiology may be the breathtaking new miracle drugs that can save your life in weeks. That's the good news. The bad news is that the vast majority of Americans with heart disease are not following even the most basic course of action -- with tragic results. Many of us need a highly customized treatment program, but few receive it. It's a lesson I learned the hard way, in the case of my own father, who died suddenly, tragically, and unexpectedly before I researched and wrote this book.This book will help you become a smart consumer, able to navigate the treacherous shoals of modern cardiology, whether you are at low, moderate, or high risk.It works. Using the exact steps in this book, my mother's life was miraculously saved when heart disease came within minutes of killing her. Copyright copy; 2005 by Dr. Bob Arnot