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Jim Otvoshttp://www.ncsu.edu/research/results/vol6/6.html is an academician/researcher/entrepreneur in nuclear magnetic resonance spectroscopy. Since the late 1960s to early 1970s, the basic science work which lead to sub-fractionation of lipoprotein particles (chylomicrons, VLDL, IDL, LDL & HDL, plus multiple sub-distinctions within these groupings) had been a breakthrough into how fats needed and manipulated by all cells in the body are carried by the water-based blood transport system; work which lead to a Nobel prize in Medicine in 1988. In the early 1990's, given increasing evidence and understanding of the role the many different lipoproteins (not cholesterol per-se) played in the usual progression of atherosclerotic disease, he began novel research work in using NMR spectroscopy to quantify the lipoproteins in first primate and then human plasma. This in turn lead to giant decreases in cost while improving accuracy.His work has led to several rewards http://www.ncsu.edu/research/results/vol6/6.html for both accuracy and, even more importantly, for great reductions in the cost to patients of having quantitative lipoprotein fractionation; it is no longer just an expensive research tool but has become low enough in cost for most physicians and patients to use the methodology to greatly improve treatment strategies and greatly reducing cardiovascular event rates without resorting to only arterial bypass surgery or angioplasty/stents to treat the symptoms of advanced disease, often after the individual has become permanently disabled.As of early 2007, the COURAGE clinical trial "COURAGE trial" http://www.ncbi.nlm.nih.gov/sites/entrez?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=17223420&dopt=AbstractPlus William E. Boden, M.D., Robert A. O'Rourke, M.D., Koon K. Teo, M.B., B.Ch., Ph.D., Pamela M. Hartigan, Ph.D., David J. Maron, M.D., William J. Kostuk, M.D., Merril Knudtson, M.D., Marcin Dada, M.D., Paul Casperson, Ph.D., Crystal L. Harris, Pharm.D., Bernard R. Chaitman, M.D., Leslee Shaw, Ph.D., Gilbert Gosselin, M.D., Shah Nawaz, M.D., Lawrence M. Title, M.D., Gerald Gau, M.D., Alvin S. Blaustein, M.D., David C. Booth, M.D., Eric R. Bates, M.D., John A. Spertus, M.D., M.P.H., Daniel S. Berman, M.D., G.B. John Mancini, M.D., William S. Weintraub, M.D., for the COURAGE Trial Research Group; Optimal Medical Therapy with or without PCI for Stable Coronary Disease: the COURAGE trial. url=http://content.nejm.org/cgi/content/short/NEJMoa070829 NEJM Volume 356:1503-1516 April 12, 2007 Number 15 , reported during the ACC convention, which compared "optimal medical therapy" with or without additional angioplasty +/- stents, demonstrated that angioplasty +/- stents did not improve survival over "optimal medical therapy". The success of "optimizing" lipoprotein levels, not just to low adult but to at or near childhood levels, before the typical onset of atheromas, the key lesion of atherosclerosis, is one of the most effective results of "optimal medical therapy".
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