Been hiking with Roya, no very strenuous training since I have a multitude of tests today.
Wildflowers at peak.
My brother had an angiogram with contrast. It was a lucky thing. He just got a new cardiologist and he only went in originally to deal with his wife's issue, which turned out to be not as serious. It was suggested HE get tested while she was there. After the angiogram, Dr. ordered an urgent heart catheterization and he was found to have 95% blockage of a right coronary artery. (She had zero blockage). He received a stent. His CAC scan was 56 and his CT angiogram with contrast suggested just 50% blockage. Both tests understated his issue. Heart catheterization surgery is really the only definitive measure of blockage. CAC is just looking back at the disease already accumulated and the CAC number means little, more about the location of the calcification. He was on Repatha and now on Plavix. Seems that Repatha does nothing to reverse the damage / disease, just supposedly decreases risk. The Dr. told him that he could have easily had a fatal heart attack, as our uncle did, without this procedure.
I have numerous Dr appointments this month, some I will not keep if my tests go well. I'll be doing the GRAIL test, lipids, A1c, CMP, tumor markers. Hope it goes well.
Semester getting really busy, student concert Thurs then it gets a little easier.
Expect to do a major hike on Friday, then resume training on the weekend with some biking and hill sprints.
Finally below 145 lbs, thankfully.
Only statins, particularly high dose statins can reverse it. But takes time and could have an event before the benefit is there. Did he absolutely have to stop the statins (Dr advice) or did he choose to?
ReplyDeleteStatins reduce cholesterol, but do not prevent heart disease.
ReplyDeleteMisleading. Nearly everyone over 50 has some level of plaque, with most being subclinical. Statins can slow or prevent any additional plaque buildup, stabilize plaque by calcification (and ironically making it visible on a CAC) and if statins are taken long enough at a dose that significantly alters the ratio reverse the disease. Like any treatment not all have a great response but many do.
DeleteQuestion remains, was he advised to stop by a cardiac physician or did he choose to?
DeleteHe is still on Repatha, which reduces LDL. After this event, if the Dr thought he needed statins additionally he would be taking them. At one point he was on them and they caused liver enzymes to be high.
DeleteMy test results are now trickling in. So far so good.
Yes he was on maximum dose as they were trying to stabilize plaque and reverse it over time. But going from maximum dose to zero for a very high risk person is inconsistent with best medical knowledge and practice as they should have stepped it down to find the balance point of not raising enzymes and maintaining the key pharmacological benefits of plaque stabilization. If they didn’t it implies the patient objected. And it is not true that if the doctor felt he needed them they would put him back on it. IF the patient over reacted to high liver enzymes and refused the treatment earlier. Medicine is not like it was 30 years ago they will not push to treat if patient does not want it. I suspect you poisoned his thoughts on statins increasing his odds of having a horrific outcome.
ReplyDelete