Cardiovascular Diseases in Minnesota

early atherosclerosis clinic, Mayo Clinic

Iftikhar J. Kullo, M.D.,
Clinical Director

In spite of remarkable advances in diagnosis and treatment, coronary heart disease due to atherosclerosis (hardening of the arteries) remains the No. 1 killer in the United States. Early onset of the disease is particularly devastating, since serious complications can affect patients in the prime of their lives.

Mayo Clinic is one of the few medical centers in the nation with a comprehensive diagnostic and treatment program for patients at risk for early atherosclerosis and for those who have already developed atherosclerosis at a relatively young age. Using the latest technology and testing available, the cardiologists at Mayo Clinic's Early Atherosclerosis Clinic can refine cardiovascular treatment plans and more effectively manage the risk of their patients.

Three Types of Patients

The Early Atherosclerosis Clinic mainly serves three types of patients:

1. Patients who have developed any manifestation of atherosclerosis including heart attack, stroke and peripheral arterial disease at a relatively young age (under age 55 in men, under age 65 in women).
2. Asymptomatic patients who have a family history of early atherosclerosis (a first-degree relative with heart attack, stroke or peripheral arterial disease prior to age 55 in men, or prior to age 65 in women) and are concerned about their risk of developing the disease.
3. Patients with abnormal levels of novel risk factors including C-reactive protein (CRP), fibrinogen, Lipoprotein(a), homocysteine, and LDL particle size.

Traditionally, patients are evaluated using conventional risk factors such as elevated high blood pressure, cholesterol, diabetes and smoking history. However conventional assessments ignore family history, obesity and other risk factors. Since almost half of all heart attacks are the first symptom of coronary heart disease, Mayo Clinic has developed additional tests to measure novel (new) risk factors and arterial function, with the goal of early detection and treatment.

Only a few medical centers are equipped to perform tests for these novel risk factors, and Mayo Clinic combines expanded testing with a comprehensive cardiology consultation and a personalized treatment plan. The services offered by the Early Atherosclerosis Clinic are:

• Novel cardiovascular risk panel: Measures levels of novel protein markers in the blood associated with elevated risk of early disease.
• CT scan of the heart: Measures the amount of calcium in the coronary arteries, an indicator of plaque buildup. This test is generally limited to asymptomatic patients with family history of heart disease, since symptomatic patients are known to have arterial plaque.
• Arterial function tests:Assess arterial health including the function of the endothelium (the inner lining of arteries), as well as the stiffness of arteries.
• Cardiology consultation: Patients meet with a card-iologist who specializes in assessment of cardiovascular risk and treatment of novel risk factors. The consultation includes reviewing test results and recommending preventive measures, lifestyle changes and medications such as lipid-lowering drugs, and if necessary, procedures such as angioplasty or surgery.

Research Becomes Practice

Researchers at Mayo Clinic helped develop the novel cardio-vascular risk marker panel and arterial function tests, both valuable in practice when assessing patients' cardiovascular risk. Current research is also focused on newer methods of detecting patients at risk for early onset cardiovascular disease and events, and how those patients can benefit from early, aggressive intervention.

Appointments

Patients may be referred by their primary physicians, or may make appointments on their own. To schedule an appointment with the Early Atherosclerosis Clinic, call 507-266-9417 Monday – Friday, 8 a.m. – 5 p.m. Central time.

Physician Staff

• Iftikhar J. Kullo, M.D., Clinical Director
• Robert D. McBane, M.D.
• Stephen L. Kopecky M.D.
• Randal J. Thomas, M.D.