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Frank M Sacks MD
Harvard School of Public Health, Boston, USA
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Frank Sacks is Professor of Cardiovascular Disease Prevention, Department of
Nutrition, Harvard School of Public Health and Professor of Medicine at Harvard
Medical School. He is a senior attending physician at Brigham and Women’s
Hospital where he has a specialty clinic in hyperlipidemia with the cardiovascular
division. He is involved in research and public policy in nutrition, cholesterol
disorders, hypertension, and cardiovascular disease. He is member of the American
Heart Association Nutrition Committee. His research program is a combination of
laboratory research on human lipoprotein metabolism, and clinical trials in
nutrition and cardiovascular disease and hyperlipidemia treatments. Dr Sacks has
140 publications of original research, and over 60 reviews, editorials, and chapters.
Dr Sacks was Chair of the Design Committee of the DASH study, and Chair of the
Steering Committee for the DASH-Sodium trial. Dr Sacks is Co-Chair of the recently
published OmniHeart Trial and was the Principal Investigator of the Cholesterol and
Recurrent Events trial (CARE). Currently, he is Principal Investigator of an ongoing
NIH funded trial on dietary approaches for weight loss and maintenance.
Recent articles by Frank Sachs
Acceptability of sodium-reduced research diets, including the Dietary Approaches To Stop Hypertension diet, among adults with prehypertension and stage 1 hypertension.
Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women.
Conflict of interest policy for Editors of The American Journal of Clinical Nutrition.
A trilogy of primary prevention statin trials. Panel discussion.
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| Presentation |
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Establishing New Biomarkers For Atherosclerosis And Their Response To Treatment
Conquering Atherosclerosis - From Science to Clinical Practice - Sponsored by AstraZeneca
76th Congress of the European Atherosclerosis Society in Helsinki, Finland
June 11th, 2007
Several factors are known to contribute to the risk of cardiovascular disease (CVD)
and interventions to modify these are governed by best practice guidelines.1–6 Patients with a history of coronary heart disease (CHD) or CHD-equivalents
(diabetes, other atherosclerotic disease, or high multifactorial risk) are considered at
high total risk of CHD/CVD, and intensive therapeutic lifestyle changes and drug
therapy to manage risk factors are advocated.
For patients with dyslipidaemia, LDL cholesterol (LDL-C) is still the primary target for
intervention. In recent years, the publication of data from several clinical outcomes
trials with lipid-lowering therapies has added to our understanding of the treatment
of dyslipidaemia. A meta-analysis from 2006 of these outcomes trials showed that
compared with placebo, LDL-C-lowering therapy reduces the 5-year risk of first
major coronary event by 23% for every 1 mmol/L reduction in LDL-C.7 The results
of some of the recent trials included in this meta-analysis were the basis for national
and international guidelines to recommend ever more aggressive lipid targets.3–6
In addition, guidelines now recognise elevated triglycerides and low HDL cholesterol
(HDL-C) as components of the metabolic syndrome, which increases CVD risk.1,2 Several other CVD lipid risk factors have been identified including apolipoprotein
ApoB, Apo C-III, nonfasting triglycerides, and highly atherogenic remnants of
triglyceride-rich lipoproteins containing Apo C-III.8,9 Direct markers of vascular
disease are showing promise including arterial intima-medial thickness,10 intravascular ultrasound (IVUS) parameters,11 and coronary calcium.12 Inclusion of
these factors in assessment of global risk could potentially improve identification
of at-risk individuals particularly within the primary prevention population,
and enable treatment to be targeted more appropriately.
References:
1. NCEP ATP III. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP)
Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel
III). JAMA 2001; 285: 2486–2497.
2. De Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in
clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in
Clinical Practice. Eur Heart J 2003; 24: 1601–1610.
3. Grundy SM, Cleeman JI, Bairey Merz CN, et al. Implications of recent clinical trials for the National Cholesterol
Education Program Adult Treatment Panel III Guidelines. Circulation 2004; 110: 227–239.
4. British Cardiac Society BHS, Diabetes UK, HEART UK, Primary Care Cardiovascular Society, The Stroke Association.
JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005;
91(Suppl V): v1–v52.
5. Ryden L, Standl E, Bartnik M, et al. The Task Force on Diabetes and Cardiovascular Diseases of the European Society
of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Guidelines on diabetes,
pre-diabetes, and cardiovascular diseases: executive summary. European Heart Journal 2007; 28: 88–136.
6. McPherson R, Frohlich J, Fodor, Genest J, Canadian Cardiovascular Society. Canadian Cardiovascular Society
position statement – recommendations for the diagnosis and treatment of dyslipidemia and prevention of
cardiovascular disease. Can J Cardiol 2006; 22: 913–927.
7. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective
meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366: 1267–1278.
8. sacks_v1 FM. The apolipoprotein story. Atherosclerosis Suppl 2006; 7: 23–27.
9. Kawakami A, Aikawa M, Libby P, Alcaide P, Luscinskas FW, sacks_v1 FM. Apolipoprotein CIII in apolipoprotein B
lipoproteins enhances the adhesion of human monocytic cells to endothelial cells. Circulation 2006; 113: 691–700.
10. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid
intima-media thickness: a systematic review and meta-analysis. Circulation 2007; 115: 459–467.
11. Nicholls SJ, Sipahi I. Emerging role of intravascular ultrasound in the assessment of experimental anti-atherosclerotic
therapies. Curr Med Chem 2006; 13: 1727–1734.
12. Hecht HS, Budoff MJ, Berman DS, Ehrlich J, Rumberger JA. Coronary artery calcium scanning: Clinical paradigms
for cardiac risk assessment and treatment. Am Heart J 2006; 151: 1139–1146.
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