Dr. Vladimir Subbotin, MD, Ph.D. – An Alternative Hypothesis for Coronary Atherosclerosis
1 AMA PRA Category 1 Credit™
In 1987, powerful hypolipidemic drugs known as statins were introduced to clinics around the United States. As Dr. Vladimir Subbotin explains, the American Heart Association (AHA), confident in the new drugs’ effectiveness for treating coronary atherosclerosis (CA), “predicted that lowering blood cholesterol by statin treatment would almost eliminate the necessity for bypass surgery and percutaneous coronary intervention (PCI), and eradicate CA by the end of the 20th century.”
“However, as we know now,” Subbotin says, “the prognosis stopped short of satisfying the predictions.” Here, Subbotin shares his explanation for why statins have failed to meet the AHA’s expectations. That failure, he claims, is due to a fundamentally flawed understanding of the pathogenesis of heart disease. Subbotin attributes this flawed pathogenesis and the resulting inadequate treatment to the widespread acceptance of the cholesterol hypothesis, which claims lowering blood cholesterol should eliminate CA. While reviewing the literature on the cholesterol hypothesis in the world’s leading medical journals, Subbotin noticed an interesting commonality. Many include incorrect portrayals of arterial histology — for instance, portraying the tunica intima as a single-cell layer of endothelial cells, which is a characteristic of only small arteries and veins. Through further review of the literature, Subbotin found, “All the publications advocating the cholesterol hypothesis consistently misrepresent the morphology of human coronary arteries.”
Based on the real morphology, Subbotin presents an alternative hypothesis for CA pathogenesis, one that suggests an opposite route for the invasion of lipoproteins into the coronary tunica intima. While the commonly held belief, particularly among supporters of the lipid hypothesis, suggests lipids invade through the arterial lumen, Subbotin claims lipid deposits develop through the vasa vasorum.
Vladimir M. Subbotin studied biology and medicine at the Novosibirsk Medical School, Russia, and obtained an MD degree in 1969. He received his Ph.D. in 1973 (study of the pathology of human placenta) under his mentor and father Mikhail Ya Subbotin. Later he worked at the Russian Academy of Sciences and, as a volunteer pathologist and now as a scientific consultant, at the Novosibirsk Zoo in Russia.
Upon immigration to the U.S. in 1991, he worked at the Thomas E. Starzl Transplantation Institute and Department of Pathology, University of Pittsburgh. In 2000, he joined Mirus Bio Corporation and now serves as the Director of Pathology at Arrowhead Pharmaceuticals in Madison, Wisconsin. He also serves as a faculty in the Department of Oncology at the University of Wisconsin and an adjunct professor in the Department of Pathology at the University of Pittsburgh.
His research interests include new theoretical and practical approaches to cancer treatment and atherosclerosis, diseases and evolution, and chordate phylogeny. His expertise on these topics is reflected in more than 150 publications.
- Understand how the pathogenesis of heart disease has been misunderstood by proponents of the popular lipid hypothesis.
- Understand the real morphology of human coronary arteries.
- Understand why statins are an ineffective treatment for CA and why research funding may be more beneficial if directed toward the study of factors that disturb the regulatory forces that affect the differentiation of arterial tunica intima in healthy cells.
Disclosures relevant to speaker:
This activity is not commercially supported.
Dr. Vladimir Subbotin, MD, Ph.D. reports no relevant disclosures related to the planning or presentation of this activity.
- Director of Pathology at Arrowhead Pharmaceuticals in Madison, Wisconsin.
- Paid content contributor to CrossFit, Inc.