I am 30 years old, the Dr said if I have any plaque I can reverse it. Confused!

[heartcreature]

I questioned my cardiologist on this too when I heard him say before a large group that plaque can be reversed. He maintained that with diet and excellent lipid control that it can be reversed. I'm hoping he knows what he's talking about. As for Crestor I wouldn't touch that stuff with a ten foot pole. I saw what damage it can do when my brother took it in a low dose. I do take Zocor and my LDL is below 70 so I'm hoping it's working.

Oh yes and I was 41 at the time so there is still hope even for us over the age of 30.

[Ken289]

Here is my strategy for trying to control cholesterol and to "reverse" plaque buildup, and to prevent restenosis. As stated elsewhere, I have had two stents and three angioplasties since May 1 to preventing further blockage and avoiding bypass.

I had been on 3g of fish oil per day along with VitC, VitE, multi...and when angina struck in late April, I immediately increased dramatically. I went to 8g fish oil, 10-12g VitC, added 3g lysine, 1.5g proline (see Pauling site for details), 100mg CoQ10, in addition to previous intakes. I also added EDTA chelation (controversial I know and more reading has made me more doubtful and I am reevaluating continuing the chelation). I also had been taking 20mg Lipitor and this was increased to 40mg. Post first angio/stent, they added 75mg Plavix. I continued my 325mg aspirin.

This resulted in LDLs dropping from 92 to 75 with HDLs in the low 35 range. Total at 170, Trig at 150. Not bad.

But...second blockage 6 weeks later, so I have adjusted further. Changed to Vytorin (10mg/40mg) which adds the Zetia sequesting agent to Zocor instead of the Lipitor. While I haven't researched it myself, my primary says that the Zocor has evidence of contributing to HDL elevation while the Lipitor does not. In addition, I added 500mg Niaspan, a slow release niacin, which raises HDL. Finally, 30mg of isosorbid, a slow acting nitro to help present spasm.

In spite of all of this, I still have plenty of PVCs (I know, somewhat unrelated to cholesterol reduction), and don't feel all that great. I plan to reenter cadiac rehab next week and will hope for the best. I do not know any other vairable knobs to try and would appreciate any new suggestions.

Hope this helps.

Ken

[Beefsteak]

heartcreature says:
"I do take Zocor and my LDL is below 70 so I'm hoping it's working."

That's a good result - but there must be something other than Zocor (simvastatin) that you are taking. How much are you taking? Can you elaborate a bit on what else you take, and your diet, if that's part of it?

Ken:
With regard to the Vytorin I think the HDL elevation comes mostly from the ezetimibe (10mg). They work well in combination and are better in raising HDL and lowering LDL than the Lipitor (atorvastatin) monotherapy. Of course the elevation of HDL is more important than lowering LDL at the sort of cholesterol levels you are obtaining.
You want to buy some time right now - to allow the medication and diet to do its work. That is long term - in the meantime you need solutions to the short term problem of stabilizing your condition. That may require different medication. I would just be careful not to cover all the bases by too many different medications - I cannot comment much further except to say that you should keep seeking advice. I'm surprised your cardio has not said do this and do that.
Lenin is your man here - he seems to have a vast knowledge on this. No doubt there are others too with experience, that have good advice.
Good luck mate with the rehab.

[Ken289]

Beefsteak (man, what clever screen names here): thanks for the encouraging words....

Can you or anyone else comment on what the difference is between an "interventionalist cardiologist" and a "regular cardiologist"?? I got hooked up with an interventionist (or interventionalist) because he was on call on my first visit to the ER. He does 4 days a week of cardio procedures and one day a week of office visits (and he was late to my visit!). I think Lenin or Fathersson said that you want an interventionalist for accuracy and experience in manipulating the balloon wire, but can the other type do anything to help me in the medicine department like you suggested.

I go to a practice which has maybe 25 different doctors, but I am unsure of the etiquette of asking to see another cardio; I don't know if this is against the "rules" of "stealing patients" or is fine and ok.

Any experience or advice in this area??

[Lenin]

I think the definitions are slightly gray. But to me a "non-interventionalist" would be someone qualified in most diagnostic procedures and medical treatments. Thus he could be a master of reading ECG's and echograms, administering and interpreting stresss tests, both nuclear and non-nuclear. He might be a good man to help control BP and blood lipid levels and monitor a heart healthy diet.

The next step MIGHT be either one: a catheter angiogram. I think some might term the percutaneous (artery snaking procedure as either.)

Then broadly 2 areas of interventionalist:
1. angioplasty and stent placement,
2. open heart procedures like bypass.

Probably some would divide them into just 2 groups: Heart Bypass and everybody else.

Definitions aside, find out what you'd PROBABLY like done and choose the appropriate cardiologist. I very much DID NOT want bypass so I chose a man with a superb record (best in NYC) at angioplasty and angiography who didn't do bypass.

I think as a bare minimum, a cardiologist who does angioplasty is about right. Less qualified than that might mean being handed from one to the other...always unpleasant for the patient...US!
Don't be afraid to tell your GP that a referral to such a doctor is an absolute necessity. You are the one footing the bills.

If for some reason, you'd like to go the bypass route , then pick a cardiologist who ONLY does bypassses...dollars to donuts, a bypass is what you'll get.