Unless someone with a high cholesterol has had an "event" (angina, stent insertion, heart attack, stroke, symptoms of peripheral vascular insufficiency) then the chances of them benefitting from being on a statin are essentially zero.
Unless someone with a high cholesterol has had an "event" (angina, stent insertion, heart attack, stroke, symptoms of peripheral vascular insufficiency) then the chances of them benefitting from being on a statin are essentially zero.
So my familial high cholesterol value was halved to put it into normal range after 3 months of statins. Are you telling me this has no value to my asymptomatic coronary artery stenosis with a calcium score of >500??
Simon Blease
Monmouth
A Coronary Artery Calcium score of > 500 is surely best regarded as an event, so we are talking about secondary prevention. From my reading, a score of 0 meant no benefit from statins; >400 meant a NNT per year of 45 - this is to prevent an event; I could not find NNT to save a life, so presumably it did not save lives, or they would have made a huge deal of it.
As a Geriatrician, I saw lots of nasty side effects from statins, and stopped them often. I also saw a death from statin associated renal failure, something that is only meant to occur in one in half a million statin treated patients - I suspect it is rather more common than that - there is no way I saw half a million people on statins, busy as my job was!
Best wishes!
What do you mean by 'event'?
Its not an event but a measure of calcium in the arterial wall that correlates with risk of myocardial event.
My cardiologist tells me that as a fit, asymptomatic individual, my major risk is sudden cardiac death. Not a risk I want to bear without making every effort to reduce it.
I was worried about medication side effects but I seem to tolerate atorvastatin,ramipril and indapamide without any undue symptoms. My biggest issue has been stopping with racing.
So what is Gambatte to do for best? I would say recheck after looking into diet etc. If still off then perhaps getting a calcium score? If that OK, then just monitor rather than starting on cholesterol normalising medication?? Oh, and Gambatte, whats your blood pressure?
Simon Blease
Monmouth
Of course calcification is a process, not an event, but the people that have had their CAC measured and have a high result are known to have a very different prognosis from those who 1/ have not had it measured 2/ have had it measured and the result is low or zero. So they fall into a different category from true primary prevention, where there is no benefit in terms of lives saved from being on a statin. Hence treating CAC as an "event". Disagree with my terminology if you wish.
Gambatte should not be on a statin - mediterranean diet, lots of fruit and vegetables, oily fish, olive oil, cut down on/eliminate meat, eliminate free sugars and highly processed foods, achieve/maintain ideal body weight ( BMI < 25 ), remain active, minimal alcohol if any, and of course don't smoke. If I was him I would not be getting a CAC score done - but then, never having had an event, I have no idea what my cholesterol is.
And I wish I knew what my cholesterol/calcium score was 10 years ago so I could have started a statin. This might have prevented the arterial narrowing that has now curtailed my racing career!
Simon Blease
Monmouth
But no symptoms? Advised not to race (or even run?) based on a high CAC score? I would be interested to hear the evidence behind this advice. It is my understanding that endurance runners tend to have a higher CAC score than the general population, yet, apart from atrial fibrillation, they have fewer cardiac events.
No Mike the advice is following a coronary angiogram that showed 30% flow restriction on 2 diagonal branches of LAD. Anyway let's focus on gambattes issue. How does he manage this one off finding for best?
But the real secret to long life, is two raw eggs a day.
So said an Italian lady living to 117.
Is it still true that amongst non smoking , non drinking , non cholesterol taking , non dusty air imbibing , non McDonald ( or Burger King) eating , non salt eating , none coke ( or sugar drink) drinking, none chip eating, healthy lifestylers , the death rate is still 100 percent? Selling funerals is still a reliable market!
Last edited by Oracle; 29-01-2020 at 10:31 PM.