<International Circulation>:What do you think about the future trend of coronary artery disease prevention? Will it be better?

Dr. Lewin: I think in twenty or thirty years， heart attack will never happen. It will be gone. I think that we will have eliminated heart attack. I think that coronary artery disease will be something people talk about in the old days- it used to happen. You know that is the way it is with stomach ulcers today. It used to be  that the number one surgery in the US was for stomach ulcer. There is no surgery for stomach ulcers today. We have medications to treat the problem before it gets very serious. Many problems that we used to treat many years ago are gone away. Rheumatic heart disease is still a problem in rural areas here in China. But rheumatic heart disease is mainly caused by an infection that starts first， the strept-throat or streptococcus infection， which you can treat very easy with antibiotics. So rheumatic heart disease should be completely gone in the future. Still many people come in the hospital for that， our vision is in twenty years， no more heart attacks， no more risk from that， we are going to other problems. We will still have heart failure， because as get older， our heart gets weaker. So we will still have heart failure， we will still have congenital heart problems. But possibly in the future we may even have ways with genetic models to eliminate some of that. Now we can’t live forever， we must die at some point. But some of the things there， the most common problems today will probably go completely away and disappear， if we do our jobs right.

<International Circulation>:What do think about aspirin in the current management of acute coronary syndrome.

Dr. Lewin: It seems like a very simple thing which is quite effective. It is very simple， very inexpensive， but yet it has a therapeutic benefit . Of course we think aspirin is important because it is such a simple intervention for acute coronary syndrome. It‘s not going to totally transform the coronary syndrome as compared to getting a stent or getting more definative therapy. But as aspirin still a major part of the therapy， and too often it is not being used.

未来冠心病预防的趋势
    在二十或三十年后，将不再有心肌梗死发作，那时我们将消灭了心肌梗死，那么冠心病就会变成人们口中的很久以前曾经有过的一种疾病，就像现在的胃溃疡一样。在美国，胃溃疡曾经是排第一位的手术疾病，但是现在已经不需要胃溃疡手术了。在疾病进展到很严重的程度之前，已用药物很好地控制住了，多年前的一些疾病问题目前已经都解决了。虽然在中国农村地区还存在风湿性心脏病，主要是由感染链球菌、链球菌性喉炎引起的。但是这种感染用抗生素治疗非常容易，所以未来风湿性心脏病应该会完全克服的。虽然现在还有很多心肌梗死患者来医院就医，但是在我看来，再过二十年，就不会再有心肌梗死，也没有心肌梗死的危险因素，那时我们会转为关注其他问题，仍会有心力衰竭和先天性心脏病。不过未来我们可能甚至会通过遗传学模型，攻克一部分先天性心脏病。人的生命都是有限的，总有走向死亡的一天。但是只要我们做好本职工作，今天面临的常见问题很有可能在将来完全解决。

阿司匹林在急性冠状动脉综合征诊治中的作用
    阿司匹林是很有效但是又很简单的一种药，物美价廉。当然我们认为阿司匹林是治疗急性冠状动脉综合征（ACS）的重要手段，就是因为它直接、简单、有效。与支架或其他更有效的治疗手段相比，它无法彻底治愈ACS，但是阿司匹林仍然是治疗中的相当重要的部分，应用很广泛。