Why statins for BAV post-op w/ squeaky clean coronary arteries?

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MrP

Well-known member
Joined
Dec 11, 2005
Messages
304
Location
California
Are statins really necessary for me? I have high cholesterol for sure (over 200 LDL), but nuclear imaging studies show my coronary arteries are squeaky clean like a baby's. I am four years post-op after BAV replacement with mechanical valve and ascending aortic aneurysm resected and replaced with Dacron graft. Statins may be necessary to reduce risk of stiffness and calcification on my remaining aorta ..arch and descending..(are statins effective here?), although I prefer to avoid statins altogether. I realize my cholesterol is at dangerous high levels when compared with the norm but understand that BAV patients many times have a protection mechanism nevertheless....and recent nuclear images show my coronary arteries look great! Thanks in advance for any insight you may be willing to share.
 
Its funny that you mention statins MrP because my doctor put me on Simvastatin yesterday. I also have clean arteries, but only a slightly elevated bad cholesterol level. She told me it is a precautionary measure and that I should not be worried at all. When I mentioned starting Simvastatin to my pharmacist he said he wished the stuff was put into the general water supply, because then there would be less heart disease. :confused:

Jeff.
 
Thanks Phyllis for looking up that thread and remembering the statin debate of 2005. My nuclear imaging study in 2007 showing squeaky clean coronary arteries makes me question again whether or not I really need to continue taking statins daily. Any insight?
 
even though your arteries are clean, your main artery (the aorta) has demonstrated a propensity to dilate. The common cause of aneurysms is atherosclerosis. So if you've already had an aneurysm withOUT atherosclerosis, imagine what would happen if you had it. Maybe the doctor is trying to prevent that situation.
 
Thanks to each of you for your reply. Better be safe than sorry I guess, as I do not want another aortic aneurysm or clogged coronary arteries down the road.
Oaktree, I'll research niacin and see if I can get my LDL lower. I've tried three different statins and have experienced muscle pain from time to time, although I'm not sure this pain is from the statins now that I look back. It may be pain from post surgery nerve firing on/off or something else other than muscles affected by statins. I like the idea of trying niacin, so I'll look into this.
Aaron, I think you make a good point about preventing atherosclerosis on the remaining aorta...thanks.
Jeff. thanks for sharing your doctor's advice. Do you know if savastatin lowers LDL and at the same time raises HDL?
Phyllis, thanks again.
 
I am wondering the same thing.

I am wondering the same thing.

My husband also has clean arteries per heart cath.

TC - 190
HDL - 32 (goal: >40)
LDL - 132 (goal: <70)
TG - 115

My first question is: What else is included in the TC number since HDL and LDL #s don't add up to 190?

About Niacin (B3) - Prescription Niacin (niaspan) is taken once a day cost around $80 a month.

OTC Niacin is much cheaper. It is not as long lasting so it requires that you take it several times a day and you are much more prone to flushing, etc. There is a very exhaustive write up about using OTC niacin along with the daily scheduling required in the book: The 6-week Cholesterol Cure by Robt Kovalski (sp?).

My husband was prescribed Niaspan by the surgeon after release from the hospital. We thought this was in place of a statin. But at his first Cardio office visit they asked if he was taking the statin (Crestor). After explaining no...blah,blah,blah. They said we could wait until the next blood test and see what the numbers were then.

Halfing the LDL number doesn't seem very likely to me. So, I am right where you are. Are there ligit benefits? Combined drug cost would be over $200 a month for us.

Would adding phytosterols be effective? I know that they must be taken with the meal.
 
Jeff. thanks for sharing your doctor's advice. Do you know if savastatin lowers LDL and at the same time raises HDL?

The only information I could find says that simvastatin lowers LDL but doesn't have much effect at all on HDL.

Jeff.
 
jeff, thanks again. Also, the other variable to consider when selecting a statin is the effect of each kind of statin on INR when taking coumadin...INR may be affected more by one statin over another.
cday, I don;t know what's included in the TC number but understand HDL and LDL don't add up to TC. Thanks for the info. regarding niacin. I've also read it is important not to combine niacin with statins....see below. By the way, I'd like to have your husband's LDL numbers....I think sometimes a high LDL is genetic and not necessarily indicative of increased risk.

Lipitor is a member of a class of cholesterol-lowering drugs called statins. The statins include lovastatin (brand name: Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor), and cerivastatin (Baycol) (Baycol was withdrawn from the market in August 2001). Statin drugs are known to cause muscle pains and inflammation around the muscle cells (myositis). It should also be noted that the risk of muscle injury is greater when a statin is combined with other drugs that also cause muscle damage by themselves. For example, when lovastatin (Mevacor) is used alone to lower cholesterol, muscle damage occurs on the average in one person out of about every 500. However, if lovastatin (Mevacor) is used in combination with other drugs such as niacin, gemfibrozil (Lopid), or fenofibrate (Tricor) to further reduce cholesterol levels, the risk of muscle injury skyrockets to one person out of every 20 to 100 who receive the combination. The risk of muscle damage is thus multiplied five- to 25-fold by using a combination of a statin and another cholesterol-lowering drug rather than by just using statin alone.

You see, statin drugs cause three types of muscle conditions. First, they can cause muscle aching. This condition generally reverses itself within weeks of discontinuing the drugs. Second, they can cause muscle pains and mild muscle inflammation that may also be accompanied by minor weakness. Blood testing for the muscle enzyme, CPK, is mildly elevated. This condition also generally reverses, but it may take several months to resolve. Third, statins can cause severe muscle inflammation and damage so that not only are the muscles painful all over the body, they also become severely weakened. Heart muscle can even (rarely) become affected. Blood testing for the muscle enzyme, CPK, is markedly elevated. When the muscles are severely damaged, the muscle cells release proteins into the blood that collect in and can damage the kidneys. This can lead to kidney failure and require dialysis.

In each of the above three forms of muscle conditions that result from statin drugs, the outcome is always much better when the condition is detected early.

There are many other medications (aside from statins) and diseases that can cause muscle aching. Of all causes, however, statin drugs are what I see as the most common culprits. If you or someone you know has muscle pains, check the medications being taken first!

Finally, please understand that the statin drugs have been shown to be the most effective (and widely prescribed) medications to optimally lower cholesterol and prevent heart attacks and stroke. This perspective article is intended to highlight the fact that even the best drugs require monitoring and can have side effects.
 
I have been on Crestor for almost 1 year now...For me the results have been fabulous...total Cholesterol is down to 120... the other numbers have also improved alot. If I remember on Monday I will go get a printout of my numbers from the Doc and post them for comparison. I was scared and hesitant at going on this med because of the stories you hear but decided to give it a go and see what I thought...I have had no bad side-effects just the good ones.

PS: I have found Crestor has indeed raised my INR by around 0.5...
 
MrP,

Thanks for the info about combining statins and niacin. I will be sure to discuss that when the next statin discussion arises.

Where was the quote from? or to make the English majors happy: From where was the quote?
 
Formula for calculating total cholesterol is:

Total cholesterol minus HDL minus the (Triglycerides divided by 5)
So here is an example Chol.=174 Trig= 296 HDL= 54 LDL=60.8
174 - 54=120
296. divided by 5=59.2
120
-59.2 equals 60.8
 
cday, the quote was taken from MedicineNet.com and written by WILLIAM C. SHIEL JR., MD, FACP, FACR, Chief Editor of MedicineNet.com.
 
All I know about statins is they don't set well with me. Twice I tried it, both times the pain was so intense I could hardly walk.
As for cholesterol I think the whole statin thing is overdone. My total cholesterol is 193, somehow I think I can live with that.
 
MrP,

My husband's Internist says that there are studies that indicate that statins will increase the longevity of tissue valves. So, my husband wants to add the statin along with the Niaspan he was already taking .. we will see how that goes. We did request generic simvastatin instead of Crestor to lessen the cost.
 

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