coumadin , plaque, vit. k2, Cyclodextrin, stopping plaque

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sfc1981

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Hi all, been awhile for me. First AVR 12 plus years ago at 50, bovine magna , lasted 10 years. Recent 2.5 years ago now 62 plus age got mechanical valve at Mayo. Went well, walked almost a mile out of hospital loved Mayo. Back in mid 50's was training for Molokai to Oahu paddle board race ( prone ) 32 miles. Anyway my cardio said if your're going to be out in the ocean doing this I want you to get a CCS, ( coronary calcium ) of your arteries. You come back clean great if not going to prescribe a statin and if I ( he ) gets my cholestrol where he wants it should stop plaque.

Now present I decided to get another CCS in the hope that the plaque is same or better , it wasn't I am now at the high end of the moderate almost to significant 389. Said calcification evident in desending aorta.
Freaking me out. I do see him to discuss results of this and echo

In the meantime been reading about plaque and everything related . I now find out the coumidin that I have to take caused plaque, frustrated that that was never brought up by anyone especially when I had to make the hard choice of which valve to use. I was basically told my call but at my age I could face additional surgeries should I go bovine.

I have read that there are a couple of vitamins, drugs etc. that say they can reduce plaque in general and from coumadin. K2 and Cyclodextrin . I am looking for additional input should anyone have any experience and or knowledge on these or any other that will stop and or dissolve plaque. I am active and have no symptoms other than still trying to lower my BP. Thank you for taking the time to read and or respond .

Steven in So Ca.
 

pellicle

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Hi

sfc1981;n882558 said:
In the meantime been reading about plaque and everything related . I now find out the coumidin that I have to take caused plaque,
You say that as if its a certainty, yet my understanding is that there is at most a weak linkage between the two.

Do you have something to clarify certainty in that casual relationship?
 
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sfc1981

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I'd have to go back thru all the sites I read to really answer that. All I know is there are a lot of sites that will tell you that coumadin causes plaque. I will discuss the results with my cardio on Tuesday and will ask him when my first calcium scan was taken and where it was at compared to where it now , just 2.5 years since I started coumadin .
My question isn't only about coumadin , whether coumadin causes plaque or not I also want feed back on the K2 and Cyclodextrin as well. Obviously this will all be asked on my visit next week. Otherwise I'm looking for opinions that are helpful.
 

Superman

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Anecdotal, of course, but having been on Warfarin 27 years, this is the first I’ve heard of this. I hope to have another 40 years on Warfarin, being in my mid 40’s. I wonder if your situation might stem from contributing factors? Kind of an “If, Then” circumstance.
 

sfc1981

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Thx. if you google coumadin and plaque etc. you'll see many opinions that feel it contributes to plaque.. Personally I am now very curious to see where the plaque was from my first scan compared to present. My cardiologist said if we got my cholestrol level at a certain point is would stop the advance and maybe reverse... again I don't remember where my score was when I started taking coumadin . We'll see stay tuned. Maybe it varies from person to person. If it's possible then I have to figure out how I can offset the coumadin with diet and other. The part I have a tough time with presently is the very drug I have to take might take me out. The CCS are a very easy and quick way to get a report within minutes of where plaque is and how you fit in with others in your age range. I would recommend that all over 50 get one done... not covered by insurance but only 199.
 

dick0236

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This is news to me too. I started taking warfarin daily when I was 31 and now am 82 without unusual calcification or "plaque" in my arteries........as far as I know. I visit with a dozen, or so, hospital patients weekly who are mostly new post-op CABG patients who have plaque buildup bad enough to require bypass surgery. Few, if any, are on warfarin and the majority are in, or approaching, their senior years (55-75). Age. inactivity and perhaps genetics seem to be a common thread.......but not their medication list.
 

pellicle

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sfc1981;n882560 said:
I'd have to go back thru all the sites I read to really answer that.... Otherwise I'm looking for opinions that are helpful.
Just make sure the sites you read are only proper scientific peer revied journals. Don't read "fluff" sites filled with ads selling you ****, or stuff that equates to wgat appears at the supermarket checkout.

Have a fish around here for posts by agian. He's put up a few about what he's done. Despite lolligagging around he knows what he's on about.

I'll do a bit of reading too, but I'm > 90% sure the plaques have a different explanation than warfarin. I mean just thinking logically about it if it was such a causal agent after God knows how many decades of use it would be iut in the mainstream already as a problem right?

PS: a post by Agian:
http://www.valvereplacement.org/forums/forum/heart-talk/866005-can-cholesterol-lowering-drugs-delay-aortic-calcification-in-a-biological-valve?p=866284#post866284
 
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pellicle

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also sfc1981 be careful when doing readings, just because you see "may cause" its instantly sloppy writing and implies poor thought in considering the data the main.

It usually means "I've found a tiny bit of evidence in the research, but I can't conclude anything, so I'll write a long list which looks great"

Correlation also does not mean causation:
[IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/img.buzzfeed.com\/buzzfeed-static\/static\/enhanced\/webdr03\/2013\/4\/9\/16\/enhanced-buzz-14835-1365541178-5.jpg"}[/IMG2]

despite what I'm tempted to believe about Justin or Farcebook

A reading:
http://cardiohub.org/wp-content/uplo...ngA12Year1.pdf

how do you fit within that? (NB, it fails to connect warfarin and doesn't specifically mention plaques, but I think they are implied with coronary artery disease)

also this page by the Mayo fails to mention anything to do with warfarin:
https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569
 
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pellicle

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lastly sfc1981 I'm sure your bummed out about this result (the plaques) but its important to work out what the actual cause is and attend to that (if possible). I'm sure that the first thing which pops up in research may be appealing (especially if it can be attributed to something you feel uneasy about anyway) but the real purpose is to turn the situation around. That's best done by finding the actual cause (and not scapegoating).

I'll keep having a dig.
 

Agian

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Warfarin interferes with K1, not K2.
I'm on Warfarin and take 2 K2 capsules daily. No problem.
They talk about green, leafy vegetables being cardioprotective. They are rich sources of K2.

Check LDL, Triglycerides, Homocysteine, Lipoprotein (a), CRP and some other crap I can't think of right now. They're your culprits.
 

cldlhd

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I take k2 as a preventative even though I only had "a bit" of calcification in one artery. I dont know for certain that it helps but I figure it's more likely to help than hurt
 

tom in MO

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I had a coronary scan because my cardio's office had a "sale" on for $100. They told me it was "recommended" but insurance wouldn't pay for it. They found "significant plaque", told me I had heart disease, a nurse gave me a good lecture and they put me on fish oil and vitamins that the insurance wouldn't pay for about $30 a month.

Then 3 years later it was valve replacement time and I needed a heart catheterization for my valve replacement. This is an invasive procedure that scopes out your vessels. Turns out my pipes were actually clean. I had plaque, but it was spotty, not thick and thus not dangerous. Turns out that's why insurance doesn't pay for a cardio scan, too many false positive results leading to unnecessary treatment and scared patients. The cardio scan detects plaque, but cannot tell how thick it is. At age 55 it's normal to have some plaque, but it's the extent and thickness that kills you. After the catherization, the nurse joked that I didn't have to get the "heart healthy menu" but they didn't serve the "regular menu" in the heart clinic. I no longer had to pay for the vitamins and fish oil.

My doctors have told me that warfarin does not produce plaque. However, in any injury, warfarin will cause you to bleed ~2-3 times more blood than a "normal" before coagulation.
 

sfc1981

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Thx Tom confused about the heart cath and your arteries were clear ? Is that what would get done should one have a fair amount of plaque ?
Done in cath lab ? Ok for aorta ? thx.

Also thx to Agian, whats the diff of k1 and k2 ? My labs are good my hdl and ldl are right where he wanted them. I was told by my cardio if we got the colestrol where he wanted it . The plaque would stop advancing. But I don't believe that's the case. I'm healthy been a gym rat all my life, except for the discussion here.
I for the most part do most everything right. Always exerised, good diet, in shape etc. that's what's frustrating and what can I do different.
I do drink more than I should , mostly red wine. So cutting back on the vino.

cldhld thx. for the input , I am going to guess my cardio might get me into the cath lab for a better look, we'll see..

Thx again to you three for constructive dialog.
 

pellicle

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tom in MO

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Thx Tom confused about the heart cath and your arteries were clear ? Is that what would get done should one have a fair amount of plaque ?
Done in cath lab ? Ok for aorta ? thx....


Before my valve replacement they put a catheter with a camera into my veins and went to the heart to check things out. This is to make sure there won't be complications or extra work needed when they open your chest. Since the imaging tool is inside the vein, it can see how thick the plaque really is. Since there is some risk associated with the procedure, it's not used for routine screening for plaque.
 

sfc1981

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yea, I've had them, I thought you were talking about a procedure where they can go in via catheter to remove plaque ? Is there such a procedure ? i guess basically I'm wondering at what point or other options are there to remove or compress plaque outside of by pass or cracking you open. Been there done that twice. What does one do as plaque advances ?

thx.
 

Nocturne

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sfc1981 I actually know a fair amount about this. You are correct, there is a pretty good amount of evidence that Coumadin increases the rate of calcification or "plaque" formation in the coronary arteries and elsewhere. However for most people this is probably not a huge concern.

Going forward, you have to bear in mind that most cardiologists and other docs really have their heads up their asses where this stuff is concerned. The medical establishment, for a variety of reasons, has not really committed to using CAC scores for much of anything, despite their accuracy in predicting heart events.

I see you were told the popular lie that a statin would "freeze or reverse" your CAC score. I was told that one too, very recently. It is not true. In fact there is ample evidence that statins INCREASE the progression of CAC! But don't freak out too much; there is also some good evidence that the increase in Agatston score from statins is at least in part due to an increase in CAC *density* brought on by accelerating the maturation of plaques from unstable to stable, which would be a good thing (more dense coronary plaques are less dangerous than less dense ones).

Why do doctors still tell patients that statins will "freeze or reverse" CAC progression? I'm not sure. Around 2005 it was the general expectation that this would prove to be the case, but subsequent studies revealed that statins do no slow CAC progression at all; in fact they seem to speed it up, as I said. So if you were told this in 2005 or so, you can forgive your doctor. Otherwise, they just haven't kept abreast of the latest news on CAC progression and statins, or they lied to you. Maybe to get you to take a statin (which you should be on), or maybe to "reassure" you.

I'm curious what your original CAC score was. A 389 score at age 62 isn't good, but it's a lot better than I'll get. My CAC was 156 at 42, and with an average progression (ascertained by looking at the MESA study data) I'll have a score of almost 1000 by the time I am 55 and about 3000 by the time I am 65. So I'd love to have your problem!

I am at work now and cannot focus much, but will write more later today or this weekend if I can. Have you ever had your Lp(a) levels checked? There is a reason I am asking.

EDIT: Check this site out:

https://www.mesa-nhlbi.org/cacreference.aspx

Lots of information about CAC. I ran the numbers for you in the reference section and assuming you are Caucasian, your CAC score puts you at the 72nd percentile for CAC for a man your age. Compare to me at the 99th percentile (worst 1%), where I am at in large part because two copies of a faulty gene raised my Lp(a) up to the moon since birth. Put another way, over a quarter of men your age would be envious of your CAC score. Not too bad!
 

dwhist

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I have not been here in awhile. In 2011 I had an angiogram completed prior to aortic valve replacement. At that time they said I had one artery at 35% blockage and would not do anything with it. In 2017 I needed another angiogram as stress test indicated blockage. Doctor came in after the angiogram and told me my arteries were better than they were 6 years ago and the one artery is at 25% now. All others were clear. Not sure how accurate the numbers can be. I felt stress test was flawed as person doing it was having a hard time getting images and angiogram proved the results were incorrect.

Anyways, I have been taking statins since 2004 and Coumadin since 2011. I take no vitamins, fish oils ect. My cholesterol was over 300 before I started taking the statins and am now around 150 with statins and other numbers coming in good at each blood test.

I did do the CAC scan back in 2009 but do not remember the score, but it was high, like in the 200's. Have not done one since.

So, in my case I do not see where the Coumadin is causing my plaque to increase and looks like the statins are helping lower them.

Not sure if this helps.
 

Agian

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Statins or any other agent cannot reverse calcification. They can however 'deflate' the plaque by helping remove the soft fatty component, making any remaining calcification more dense. This will not be reflected in a reduction of CAC score. Remember, that calcification evolves from soft plaques, which can be reduced and even reversed with aggressive treatment. The calcium that remains is there for ever.

Being totally objective, there is no real evidence that Warfarin causes calcification. It has been discussed before. Warfarin works on K1, K2 is cardioprotective. Hence, the confusion. Pellicle dug up some research in Warfarinised rats that showed some increase in calcification. I think it's bloody hilarious that they gave the rats rat poison and they lived long enough to die of heart disease. That's a classic.
 

Nocturne

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Well, Esselstyn and his ilk would swear that you CAN in fact reverse calcification through diet and moderate exercise... And if it's possible to do it that way, then it should theoretically be possible to do it with medicine as well. But not any medicine we have at this time.

I think the research backs up Agian's claim that statins accelerate the maturation of plaque from less dense, less stable plaques to more dense, more stable ones. I have read one study, however, which involved the participation of Dr. Budoff (one of the foremost authorities on CAC), in which that theory was called into question. Basically, the study examined CAC growth over time and compared a group of people who had been on statins for a long time to a group of people who had just started a statin. If all the statin did was mature plaque, you would expect that the group that just commenced statin use would show more rapid "progression" of CAC that would gradually taper off to a rate similar to the group that had been on a statin long term. But that's not what was found. What was found was that BOTH groups had accelerated CAC progression, which again called into question the theory that statins only MATURE plaque that already exists.

Agian, there IS ample evidence that warfarin causes calcification in humans. Yes, this HAS been discussed here before, and you and I were involved in the discussion. I'm not going to rehash it here -- you are free to believe what you want, it won't change reality. The research is out there for you to find easily enough. What I do recall from that old discussion was coming to the conclusion that while Warfarin use may significantly increase calcification and therefore CAC growth, it probably doesn't do so to the extent that the typical Warfarin user should be all that concerned about it. HOWEVER - if you're a freak of nature, and your CAC score is on the moon (worst 1% for your age), to the point where you can project that at an AVERAGE growth rate you will reach a "critical mass" of a CAC score over 10,000 before, say, 80, then you might want to take Warfarin's CAC growth acceleration into account when you decide which sort of valve to have installed.

The OP is not, in my opinion, in that position. Very very few people would be - or so you'd think. But remember that people with ungodly levels of Lp(a) will also be more likely to have aortic valve stenosis AND more likely to have obscenely high CAC scores. So maybe not as rare as you'd think.
 
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