eagleheart
03-02-2006, 01:47 PM
I have CAD - 30% block in the right coronary artery and 40% in the left coronary artery. Doctor has me on Lipitor 40 mg. I also take Vitamin C, E, and lysine in therapeutic doses (5g, 1g, 2g). My latest lipid scan came back: TC - 91; LDL-34; HDL-48: VLDL - 9. Triglycerides - 44. Also had C-reative Protein reading of .124 and homocysteine level of 7.6. Doctor told me all those numbers are great - medication and supplements are working. Then I had one more test two weeks ago for Lipoprotein(a) level - my score came back at 134 mg/dl. The doctor is astonished - says that my level is at least twice what is should be and maybe more. I'm really anxious about this since I've since read that lipoprotein (a) is actually a better indicator than LDL for someone with CAD having a heart attack. Doctor is now talking about putting me on extended release niacin at a high level - like 2g - which I heard is dangerous to the liver. Am alternating between high anxiety and confusion at the moment.
Does anyone have any insight on lipoprotein(a) as a separate risk factor for heart attack for a person with CAD? I am at a loss to understand how I can have such a good LDL reading and a staggeringly bad lipoprotein (a) level.
Does anyone have any insight on lipoprotein(a) as a separate risk factor for heart attack for a person with CAD? I am at a loss to understand how I can have such a good LDL reading and a staggeringly bad lipoprotein (a) level.
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NHone
03-02-2006, 07:47 PM
Yes... as we have said before, Lipitor is know to raise Lpa. By the way your risk of adverse reactions to statins goes way, way, up when it is given with naicin. Besides you total cholesterol is way to low.
eagleheart
03-02-2006, 09:01 PM
I thought the lower the better for TC, no?
Haven't found any material on Lipitor and Lipoprotein(a). Need to educate myself - can you direct me to some resources?
I got to thinking ... is lipoprotein (a) a sub-component of HDL and LDL, or part of other things? My LDL and HDL together are 82, so I'm wondering if the 134 reading may be inaccurate. :confused:
Haven't found any material on Lipitor and Lipoprotein(a). Need to educate myself - can you direct me to some resources?
I got to thinking ... is lipoprotein (a) a sub-component of HDL and LDL, or part of other things? My LDL and HDL together are 82, so I'm wondering if the 134 reading may be inaccurate. :confused:
NHone
03-02-2006, 11:43 PM
I thought the lower the better for TC, no?
Haven't found any material on Lipitor and Lipoprotein(a). Need to educate myself - can you direct me to some resources?
I got to thinking ... is lipoprotein (a) a sub-component of HDL and LDL, or part of other things? My LDL and HDL together are 82, so I'm wondering if the 134 reading may be inaccurate. :confused:
I'll look through my files and find the lipitor and Lp(a) information...its here somewhere.... Lp(a) is a different reading (value) than the cholesterol numbers. You won't be able to use any formula to pull it out of cholesterol test numbers...If you look up Statin Study.. you can find some more information that might be helpful to you.
Haven't found any material on Lipitor and Lipoprotein(a). Need to educate myself - can you direct me to some resources?
I got to thinking ... is lipoprotein (a) a sub-component of HDL and LDL, or part of other things? My LDL and HDL together are 82, so I'm wondering if the 134 reading may be inaccurate. :confused:
I'll look through my files and find the lipitor and Lp(a) information...its here somewhere.... Lp(a) is a different reading (value) than the cholesterol numbers. You won't be able to use any formula to pull it out of cholesterol test numbers...If you look up Statin Study.. you can find some more information that might be helpful to you.
janeslk
03-03-2006, 11:54 AM
Eagleheart, what was your TC before developing CAD? I am finding it fascinating that the Lp(a) number may mean more than the LDL number. Did your doctor want you to have the Lp(a) test? My husband's doctor refused to authorize a test for this. Just curious.
Jane
Jane
Lenin
03-03-2006, 11:41 PM
eagleheart,
I'm in the same boat but with Lp(a) of 50...which I thought was super-high.
I am getting a little luck with slo-niacin but I do only 500 mg./day. (with 20 mg. Lipitor)
I think the risk of 2 grams niacin and 40 mg. Lipitor is too risky.
If I were you, the FIRST thing I'd do is get a retest on the Lp(a)...If you have parents, ask them to test also because there's a high degree of familiarity with high Lp(a.)
I wish I could tell you something works, but I am against a stone wall with it. There is some evidence that it's evil is worked in the presence of a high LDL. Yours is the lowest I've ever seen...keep it there. That's the approach I am using.
I really think that continuing to keep your cholesterol as low as you have it will cause a reduction in your plaques and you will never need intervention.
My feelings about the megadosing with ascorbate, and a few extra amino acids is that they are a waste of money as a way of treating high Lp(a)...no studies have shown corroboration.
Alcohol and heavy exercise didn't budge my Lp(a)... only niacin to a slight extent was of any use. The literature is replete with references to only tow agents that lower Lp(a) niacin and estrogen...not so great for guys.
I think there will be more data on Lp(a) coming out of studies soon because it IS an independent risk factor of importance. I'll pass on anything I find.
This paragraph from the CLEVELAND CLINIC is informatiove:
Prospective studies, on the other hand, present a slightly more complex picture. Some studies suggested Lp(a) is a strong, independent predictor of coronary heart disease, particularly in women and young men, while others found no such association. One recent prospective trial found that while Lp(a) did not independently increase coronary heart disease risk, it seemed to increase the risk of elevated total cholesterol, LDL-C, and apolipoprotein B (the major lipoprotein of the atherogenic lipids), and blunt the cardioprotective effect of high levels of HDL-C. Similarly, in a cohort of patients with premature coronary heart disease, Lp(a) was associated with extremely high relative risk only in the presence of elevated levels of total cholesterol or an increased ratio of total cholesterol/HDL-C. These interactive effects on risk were an order of magnitude greater than the impact of the lipid abnormalities alone. Another recent study of men with documented coronary heart disease and elevated levels of both LDL-C and Lp(a) found that Lp(a) seemed to lose its atherogenic potency once LDL-C was aggressively lowered.
Of note: No prospective clinical trial has been conducted in which the value of reducing elevated levels of Lp(a) has been confirmed.
I'm in the same boat but with Lp(a) of 50...which I thought was super-high.
I am getting a little luck with slo-niacin but I do only 500 mg./day. (with 20 mg. Lipitor)
I think the risk of 2 grams niacin and 40 mg. Lipitor is too risky.
If I were you, the FIRST thing I'd do is get a retest on the Lp(a)...If you have parents, ask them to test also because there's a high degree of familiarity with high Lp(a.)
I wish I could tell you something works, but I am against a stone wall with it. There is some evidence that it's evil is worked in the presence of a high LDL. Yours is the lowest I've ever seen...keep it there. That's the approach I am using.
I really think that continuing to keep your cholesterol as low as you have it will cause a reduction in your plaques and you will never need intervention.
My feelings about the megadosing with ascorbate, and a few extra amino acids is that they are a waste of money as a way of treating high Lp(a)...no studies have shown corroboration.
Alcohol and heavy exercise didn't budge my Lp(a)... only niacin to a slight extent was of any use. The literature is replete with references to only tow agents that lower Lp(a) niacin and estrogen...not so great for guys.
I think there will be more data on Lp(a) coming out of studies soon because it IS an independent risk factor of importance. I'll pass on anything I find.
This paragraph from the CLEVELAND CLINIC is informatiove:
Prospective studies, on the other hand, present a slightly more complex picture. Some studies suggested Lp(a) is a strong, independent predictor of coronary heart disease, particularly in women and young men, while others found no such association. One recent prospective trial found that while Lp(a) did not independently increase coronary heart disease risk, it seemed to increase the risk of elevated total cholesterol, LDL-C, and apolipoprotein B (the major lipoprotein of the atherogenic lipids), and blunt the cardioprotective effect of high levels of HDL-C. Similarly, in a cohort of patients with premature coronary heart disease, Lp(a) was associated with extremely high relative risk only in the presence of elevated levels of total cholesterol or an increased ratio of total cholesterol/HDL-C. These interactive effects on risk were an order of magnitude greater than the impact of the lipid abnormalities alone. Another recent study of men with documented coronary heart disease and elevated levels of both LDL-C and Lp(a) found that Lp(a) seemed to lose its atherogenic potency once LDL-C was aggressively lowered.
Of note: No prospective clinical trial has been conducted in which the value of reducing elevated levels of Lp(a) has been confirmed.
eagleheart
03-05-2006, 09:32 PM
I was diagnosed in June 2005 with CAD when I had a TC of 205 and LDL of 143. Been on the Lipitor program since then. I actually asked the doctor for the Lip(a) test in January 2006 because a neighbor mentioned it to me; my doctor had to look it up, but said he would do it because lip(a) can be considered an independent risk factor for a heart attack and he wanted to put my mind at rest. Unfortunately, the Lip(a) result was not good in my case. I did not have the test prior to the diagnosis of heart disease, so I don't know what my reading was in June 2005, but given my so-so cholestorol/LDL readings then (certainly not indicative of moderate-severe heart disease), it probably wasn't good.
eagleheart
03-05-2006, 09:56 PM
Lenin, your post regarding the Cleveland clinic helped me a lot. Since I have premature CAD, my relative risk of heart attack seems high (according to Cleveland study) only in the presence of high TC or increased TC/HDL-C ratio. The low LDL also seems to lower the Lip(a) risk.
My doctor said the same thing about the megadosing of Vitamin C and amino acids - waste of money. It probably is ... don't know. But it's not harmful as best I can tell, and there have been some indications that Vitamin C does lower TC and LDL. I forgot to mention that I also took EDTA chelation in an oral supplement form in July 2005 and take it 3 times a week now - one dose of 575 mg in the morning on an empty stomach. Doctor said the same thing about the EDTA as the vitamin C and amino acids - another waste of money, but if it makes you feel better, okay, as long as you don't go off the medicine for the quacky stuff.
All I know are the numbers; he can't explain my extremely low TC/LDL blood levels; he expected to get TC/LDL of something like 150/95 with Lipitor treatment. The difference in expectation and result could be the EDTA, the vitamin C, or not; don't know. The low LDL seems to be the key though; will try to stay the course with that.
Thx again for your informative post. I feel a lot better now.
EH ;)
My doctor said the same thing about the megadosing of Vitamin C and amino acids - waste of money. It probably is ... don't know. But it's not harmful as best I can tell, and there have been some indications that Vitamin C does lower TC and LDL. I forgot to mention that I also took EDTA chelation in an oral supplement form in July 2005 and take it 3 times a week now - one dose of 575 mg in the morning on an empty stomach. Doctor said the same thing about the EDTA as the vitamin C and amino acids - another waste of money, but if it makes you feel better, okay, as long as you don't go off the medicine for the quacky stuff.
All I know are the numbers; he can't explain my extremely low TC/LDL blood levels; he expected to get TC/LDL of something like 150/95 with Lipitor treatment. The difference in expectation and result could be the EDTA, the vitamin C, or not; don't know. The low LDL seems to be the key though; will try to stay the course with that.
Thx again for your informative post. I feel a lot better now.
EH ;)
HubbleRules
03-05-2006, 10:58 PM
eagleheart,
I agree that now that you have been diagnosed with CAD, you need to keep your LDL low...
I would continue the vitamin-c and vitamin-e however, since you also want to keep Oxidized LDL to a minimum. Look up 'CD-36' and 'SRA' cholesterol receptors. THey tend to latch on to 'oxidized' cholesterol far, far more than unoxidized cholesterol - and accumulate them into plaques... Keeping LDL from becoming oxidized is very important in preventing or reversing CAD...
Indicentally, your TC of 205 and LDL of 143 were barely considered 'borderline high' even by the revised ATP III guidelines. Makes me continue to wonder why so many with normal or low cholesterol levels develope CAD if high-cholesterol is such a major CAD factor... There is more to CAD than just bad cholesterol numbers - high Lp(a), high CRP, low HDL, high Homocysteine are also a big part of the picture.
But, studies have indicated that when LDL goes <= 70, atherosclerotic progression stops. So in your case, I'd try to keep the LDL as low as possible, but I would NOT give up the anti-oxidants...
HubbleRules
:cool:
I agree that now that you have been diagnosed with CAD, you need to keep your LDL low...
I would continue the vitamin-c and vitamin-e however, since you also want to keep Oxidized LDL to a minimum. Look up 'CD-36' and 'SRA' cholesterol receptors. THey tend to latch on to 'oxidized' cholesterol far, far more than unoxidized cholesterol - and accumulate them into plaques... Keeping LDL from becoming oxidized is very important in preventing or reversing CAD...
Indicentally, your TC of 205 and LDL of 143 were barely considered 'borderline high' even by the revised ATP III guidelines. Makes me continue to wonder why so many with normal or low cholesterol levels develope CAD if high-cholesterol is such a major CAD factor... There is more to CAD than just bad cholesterol numbers - high Lp(a), high CRP, low HDL, high Homocysteine are also a big part of the picture.
But, studies have indicated that when LDL goes <= 70, atherosclerotic progression stops. So in your case, I'd try to keep the LDL as low as possible, but I would NOT give up the anti-oxidants...
HubbleRules
:cool:
ARIZONA73
03-05-2006, 11:23 PM
My doctor said the same thing about the megadosing of Vitamin C and amino acids - waste of money.
Well, what did you expect? Doctors don't know anything about this anyway, since our brilliant medical profession has been so reluctant to study it. Just keep the doctors and their patients in the dark, while rewarding drug companies! That's their motto.
Well, what did you expect? Doctors don't know anything about this anyway, since our brilliant medical profession has been so reluctant to study it. Just keep the doctors and their patients in the dark, while rewarding drug companies! That's their motto.