Guidant sees vulnerable plaque as emerging opportunity in CV market

OCT may be enabling technology

Analysts have pegged vulnerable plaque as one of the next big developments in interventional cardiology. With its sponsorship of a recent Massachusetts General Hospital study utilizing optical coherence tomography (OCT), Guidant has staked a claim on that emerging area.

Researchers have determined that vulnerable plaque is the chief culprit behind heart attacks. These plaques are susceptible to rupture, causing blood clots and, ultimately, myocardial infarction. Current imaging procedures, such as intravascular ultrasound (IVUS), don't provide enough resolution to identify vulnerable plaque. OCT, with a resolution 10 times sharper, might be used to identify these plaques, raising the prospect of preventive treatment.

"It's a long-term interest of ours to look at these promising invasive diagnostics and see if they can do what they need to," said Bob Jones, group manager for new ventures marketing at Guidant.

The Indianapolis-based provider of cardiovascular therapies could use a winner. In early October, a U.S. District Court ruled in favor of competitor Boston Scientific to block Guidant and its partner Cook from developing a type of drug-eluting stent, potentially forcing the company to abandon the research done so far on this new type of device. Guidant executives have said publicly they will seek a stay of the injunction and appeal the judge's ruling.

The vulnerable plaque market, however, may provide a better opportunity. Analysts estimate that the market for diagnosing and treating vulnerable plaque will reach $10 billion over the next decade. The number of companies developing new products or enhancing existing ones to find vulnerable plaque is increasing. Among the possibilities are thermography, IVUS, near-infrared spectroscopy, MRI, and CT.

For the moment, OCT, which uses a light fiber inside a catheter to assess lesions and surrounding vascular tissue, appears to be in the lead. The Guidant-sponsored MGH study, which involved 63 patients with coronary heart disease, found that OCT is able to successfully and reproducibly identify unique characteristics of potentially vulnerable lesions.

While Guidant describes its involvement with OCT and vulnerable plaque as "market development," it may also reflect a new strategic direction for the company.

"We're very open-minded to (a range of ) therapy-enabling diagnostics," Jones said. "This could be a commercially attractive opportunity, not just to sell the diagnostic, but to bundle it with a therapy, or to at least give a clinical pathway from the diagnostic to the therapy."

Unforeseen hurdles may arise along the way, both in developing and marketing the technology for these applications, Jones said. But the company is aiming high.

"Our goal is to lead the market," he said. "We would like to be considered the vulnerable plaque leader. That's a fairly broad statement--but we'd like to grow into it."