Eugene Braunwald: Maestro Of American Cardiology  pg. 7

For five “nail-biting” years, Braunwald’s team waited for the results, which ultimately showed that patients who took pravastatin to lower serum cholesterol indeed reduced their risk for having another heart attack, stroke, or dying of cardiovascular causes.

More recent TIMI trials have examined the effect of driving cholesterol levels even lower, and have found not only that “lower is better,” but that “much lower is much better.” TIMI investigators are currently studying the effects of reducing a patient’s LDL to a level in the 50s, levels undreamed of ten years ago.

“We’ve followed all of these patients extremely carefully and we don’t see any serious side effects with even extreme cholesterol lowering,” says Braunwald. “We have not yet reached the (LDL-concentration) floor.”

For more than a half century as an academic physician-scientist, Braunwald has been instrumental in numerous discoveries that have saved millions of lives, and, for the record, he has no plans to stop anytime soon.

Now married to his second wife Elaine, formerly a senior hospital administrator, and a grandfather of seven, he is editing Harrison’s for the eleventh time and is leading methods for moving the textbook into the digital age. He is also piloting new TIMI trials, including several that test the therapeutic potential of novel anti-platelet agents.

He and his team recently began active planning of the fiftieth TIMI trial, even as he ponders how genetics and information technology will rewrite the score of cardiology.

“The principal task of the cardiologist in 2007 is to diagnose, assess, and treat established cardiovascular disease,” he says. “As a consequence of the revolution in human genetics, the principal role of the cardiologist by 2027 will be to interpret the patient’s genetic information and from this develop a plan personalized for each patient for the prevention of cardiovascular disease.”

Braunwald has left a huge imprint on basic science, translational research, clinical trials, and medical education. He has moved easily between the laboratory, the bedside and the classroom. But perhaps his true genius lies in his ability as the “grand maestro” of cardiology to comprehend the big picture, even as he stands in the middle of it—responding to tones, harmonies and nuances in the cavalcade of processes that are unique to the beating heart.

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