Connect
coronary plaque findings
I am a 60 year old male and a non smoker and have found out this morning that my CT Heart Angiogram has identified minor atheroma with no obstructive coronary disease.
I am been told that I qualify for "preventative statin therapy" Not sure how serious this diagnosis is in the longer term or if these plaques are pretty normal for someone my age. The consultant was rather vague and seemed very "matter of fact" ...do I have any cause to be worried?
Many thanks
Antonio
Like
Helpful
HugInterested in more discussions like this? Go to the Heart & Blood Health Support Group.
Connect
My father was in a similar situation—low cholesterol and triglycerides, but did have plaques and he was put on the highest dose of a statin (it was the generic of Lipitor). He really didn’t tolerate it well and it caused a lot of problems for him.
Through that process we learned that at least in the US, they look at treatment for this as all about how to lower risk of a stroke or heart attack. There’s even a “risk calculator” for physicians and if you fall within certain criteria it guides what the physicians are supposed to recommend—this sounds a little like the comment that was made about how you “qualify” for statin therapy. There’s not necessarily a hard and fast rule, but perhaps the amount of plaques you have falls within the amount that research shows you’d benefit from a statin? Meaning, it would lower your risk of a cardiac event.
The other thing we learned is that statins aren’t just meant to lower cholesterol; they also prevent the plaques you have from breaking off and causing a heart attack or stroke. In my dad’s situation, that’s why it was prescribed.
It is normal to have more plaque buildup as you get older. But sometimes these things can get very gray. Statins are one tool in the toolbox to lower risk; it’s a stronger and more “effective” tool (as far as lowering cholesterol and preventing the plaques from breaking off) than diet and exercise, but does everyone need that tool or is it the right one? That’s harder to say—all they can really say is it “lowers the risk.” (But I am not a medical professional; that’s my interpretation of why my dad was recommended the highest dose statin with normal cholesterol.)
Can you talk more to a GP/PCP to help you interpret the results and understand your risk, and the pros/cons of statins? It seems that would be helpful if you were only told you “could” take them.
-
Like -
Helpful -
Hug
2 ReactionsCheck PrevMed health online. Dr Ford Brewer
It is so unfortunate that the medical community is as split over the efficacy, and dangers of, statins as the world is over politics, left or right.
Statins don't have a great track record, even decades after they were approved for use. The research was fudged, as it has been for fats and vegetarian diets, for sugars of all kinds....it's a mess. I watched a video last night by yet another cardiologist who showed what appeared to be 'bone densities' (showing as white marks) on chest imaging of the hearts of a few patients who had taken statins for a few years. He said the evidence is clear, that statins actually promote calcium deposition in some people's arteries. Even in cases where they don't, the all cause mortality rates for statins are poor, meaning you have to treat 1000 people with moderate dosages for ten years to save something like 10 lives! If the calcium deposition problem is true (and I can't argue either way), then maybe statins kill hundreds who might have lived another five years or more.
One personal anecdote which I hope you can accept as truthful and exemplary: I developed atrial fibrillation and had to have my pulmonary veins isolated in the left atrium. This is done with a catheter inserted in the groin, run up through to the heart, and the wand at the end makes small burns around the mouths of the pulmonary veins, which isolates them electrically when scarring forms later. Before this, though, I had to have multiple imaging and an angiogram to see if I have heart disease...atherosclerosis. That has to be fixed first or the fibrillation will just return because of the atherosclerosis. Now, to the point: the angiogram and a later Doppler ultrasound of my carotid (neck) arteries showed 'minor deposition'. I'm 69 by this time, well into the aged males' typical heart condition....except that I'm in really good shape according to those two diagnostics. So, why am I on a statin...is what I asked my GP and the cardiologist? Both said, straight-faced, 'It will help you to live longer.' No measurable heart disease, clear arteries, already advanced in age, male,......but I have to take statins? Nope.
-
Like -
Helpful -
Hug
1 ReactionWhile we were on keto I watched several presentations on Low Carb Down Under
By David diamond. Very interesting.
https://youtu.be/rL9uabr-TeA If your BMI falls below 25, your chances of having high/abnormal LDL levels rises.
I have no plaque and LDL under 100, but still placed on statin due to type 1 diabetes. I think all type 1s are prescribed statin….regardless. Idk
My husband has a high calcium CT score . He has been on a statin for years prior to this . His cardiologist said the statin actually helped him since it stabilizes the sticky plaque that is more dangerous than the stable calcified plaque .
Thoughts ?
Your husband’s cardiologist is correct. Medium-to-high intensity statin therapy will shrink atheromas, and as those atheromas get smaller then tend to calcify more thereby stabilizing them so they don’t rupture. This was the observation of The Cleveland Clinic in 2015.
Just Google: “ Plaque Paradox: Statins Increase Calcium in Atheromas Even as They Shrink Them” https://consultqd.clevelandclinic.org/plaque-paradox-statins-increase-calcium-in-coronary-atheromas-even-while-shrinking-them
lp77,
I agree with fortunateoldguy - statins will cause the cholesterol deposits to calcify, leading to higher scoring than one might expect on CAC test. This is, from my reading, and my cardiologist and PCP, as well.
What was your husband's CAC score, and how long (specifically) had he been on statins PRIOR to that scoring?
-
Like -
Helpful -
Hug
1 ReactionIt was close to 800 . We were quite surprised . He is not overweight but has had issues with high cholesterol and high LDL . He has been in a statin for 18 years prior to to calcium CT scan . He has adopted the Mediterranean diet , more cardio . He passed stress test , EKG was good .
Just will stay on top of it with diet , exercise. He was also prescribed zetia to help get LDL down to 55 .
He always enjoyed eating whatever he wanted but now is very serious about diet .
Hereditary part : High family cholesterol.