Anyone heard of this statin side effect?

[pasdetrois]

My friend went on statins (don't remember which one) a couple years ago after having very high numbers. Within a month or so he had a heart attack while playing basketball. (His symptom was nothing more than a sore shoulder.) He was told that the cause was "a piece of cholesterol/plaque that had broken off because of the statin." He went into cardiac rehab and is now fine. When I told this story to my doctor (not a cardiologist but who ordered my labwork and wants me on Lipitor), she kind of sniffed it off and said that this type of incident had also been considered in the course of some big health study. She stated that my friend probably would have had the heart attack anyway. But I'm sure that he told me they could "see" the chunk of whatever it was when they did his tests in the ER and ICU. So I'm concerned about this and the fact that my doc dismissed it so easily and is pushing the statins. Is this an event that does happen and if so is it often? Thanks for any advice.

[butterflytrans]

Actually, it's quite the opposite. There is a new body of evidence emerging that suggests that statins actually help AVERT heart attacks because they can stabilize plaques in the artery wall. The center in my city is routinely giving statins to those coming in with acute myocardial infarctions because it seems to help with reducing mortality!

[zip2play]

A lifetime of plaque bulids and builds...a heart attack is caused when one of these plaques rupture and the freed piece causes a clot to form on it and it plugs a narrower part of an artery downstream... This is America's biggest killer and is caused primarily by a lifetime of poor eating habits. Nothing unique about finding the piece of plaque...How did they find it? Often it's on autopsy.

Of course it's quite logical (and elementary fluid dynamics) that the plaque will break off when the blood is flowing fast and hard.
It was the basketball game that broke off your friend's plaque but then something would have eventually unless years of the statin reduced it's size (and there's beginning to be some evidence that Lipitor can do exactly that, given enough time.)

I'm glad your friend's heart didn't sustain much damage...
Did he go to the ER with a sore shoulder? Most people wouldn't.

[butterflytrans]

The thing is, zip2play, is that the plaque doesn't form inside the artery's lumen...instead, it forms between the innermost layer of the artery wall and the middle layer of the wall (the tunica intima and media respectively)....also, a piece of the plaque doesn't necessary break off, but the inside wall of the artery becomes weak, it kinda tears and the underlying plaque is exposed. This sets off the clotting cascade and you get the clot formed. The only reason I know this is 'cause I got nailed on an exam once asking where the plaque is actually located.

Don't want to step on anyone's toes, just wanted to bring this little tidbit of info up

[zip2play]

Originally Posted by butterflytrans

The thing is, zip2play, is that the plaque doesn't form inside the artery's lumen...instead, it forms between the innermost layer of the artery wall and the middle layer of the wall (the tunica intima and media respectively)....also, a piece of the plaque doesn't necessary break off, but the inside wall of the artery becomes weak, it kinda tears and the underlying plaque is exposed. This sets off the clotting cascade and you get the clot formed. The only reason I know this is 'cause I got nailed on an exam once asking where the plaque is actually located.

Don't want to step on anyone's toes, just wanted to bring this little tidbit of info up

Butterfly,

I agree completely with the mechanism, but I still assert that the slow process of plaque formation and arterial weakening is climaxed suddenly, most often at a moment of high blood pressure, high blood flow, high heart rate....the basketball game. There is always a proximate cause....often shovelling now, or god forbid, SEX!
And I also think that the clot doesn't necessarily always form in place but often on the floating detritus moving downstream from the rupture. I don't have a solid foundation on the latter opinion though (never stopped me before )

Truth be told, when I've read that Lipitor has been showing some evidence of long time plaque reductions, I can't say I haven't worried just a bit that maybe leaving them in peace might be safer. (I'm thinking about the analogy of ripping apart a spent nuclear reactor... )

Never worry about stepping on these Size 12's....they're tough as, well, shoeleather?

Butterfly,
Can you help me picture the mechanism whereby angioplasty COMPRESSES the plaques to a smaller size. I think of plaque as mostly fat which like all liquids, gels, what have you, is incompressible. Where does it go....or is it a spongelike structure where pressure can force a liquid component out (into the bloodstream?). Or is it just squooshed out into a longer thinner plaque within the artery wall?