Science, medicine, and the future - The future of the management of ischaemic heart disease

Ischaemic heart disease will kill over 150 000 people in the next year in Britain, more than any other single disease process, and cost more than pound 1.4bn in health care alone. Faced with the continuing problems arising from ischaemic heart disease cardiological clinician scientists are moving from technology based solutions to basic sciences. This article explains how basic science may contribute to new understanding and treatments for patients with ischaemic heart disease. Highlighted are three problems which face any clinical cardiologist on a daily basis and for which basic science may provide solutions: the uncertainty of plaque stability in coronary disease; restenosis after percutaneous transluminal angioplasty; and the shortage of organs for cardiac transplant programmes for patients with heart failure.