Back in 2008, I was diagnosed with AFIB and, after an echo, was also told that I had a bicuspid aortic valve. An ablation in 2018 lasted only 8 months and I was soon back in afib and back on rhythm and rate meds. Fast forward to this past March when I got Covid and my paroxysmal afib turned to persistent afib. It was determined that my bicuspid valve was severely stenosed and needed replaced. Leading up to that surgery, which was a little over two weeks ago now, there were many tests, including a heart cath in which they check for blockages. Turns out, I had two almost complete blockages. Neither was a huge concern because they were lower in the heart and my body had amazingly grown another artery to compensate. I think they call it a collateral artery or something like that. Anyway, I have been on a statin med for over 20 years and am wondering why I had any blockages at all. Any thoughts? Would have been much worse if I hadn't been on statins?; statins are actually not effective; any other ideas?
yhnx
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Jafib
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Very much a Marmite question. There are some benefits, main one being statins are a powerful anti inflammatory. The process of Arteriosclerosis is complex and not yet fully understood but what is becoming clear is that it has less to do with cholesterol levels and much more to do with injury to the interior wall of the artery, the causes of which are still being investigated but thought to be diet ie: processed foods and red meat and high sugar intake.
The main benefit of statins, as explained to me by my doctor, is they are powerful anti inflammatory. Some people seem to tolerate statins whilst others don’t. I am someone who is not even going to try because they are known to exacerbate another condition I have. Instead I watch my diet, especially sugars, tend to eat quite high fat/protein/whole carbs in good proportions and take Reserveratrol which is a natural anti inflammatory.
There is a lot of pressure from doctors to take statins, GP’s are incentivised through government to have ‘the statin conversation’ which makes me somewhat skeptical. The result is that I believe statins are over prescribed and myths about them abound within the medical profession as well as the general public.
Having said that, if you have a history such as yours - I would consider the risk:benefits of taking them but as I believe quality of life is more important to me than longevity (which most of the medical profession seem to be obsessed with right now - I ask myself why?) I would probably at my grand age of 73 not worry about having a heart attack or stroke as long as I thought it would kill me. In my case I have no history of CVD in my family, I have none of the high risk factors but my cholesterol is higher than most doctors would like. I am happy living with that as I am more worried about my brain function than my heart function. Brain needs fat.
You ask the question why having been on statins you still had blockages and are they effective? Any prophylactic treatment will lessen risk but very rarely, if ever, eliminate risk. So many other factors - BP, Lifestyle and Nutrition, Genes, Exercise.
If you take statins but still eat processed foods (such as supermarket bread, processed meats, white carbohydrates etc) your risks will be rise.
What I think is appalling is that the Food Industry made us ill in the first place (back in the 1950’s - 1990’s we were all told that cereals for breakfast were good for us and eggs bad) so the Pharmacetical industry had to come up with a drug to counter the effects.
That’s what I think.
I am very sorry you have had this experience but at least it was discovered before devastating consequences so heal, look after yourself with diet and exercise and enjoy your life. I also believe that perception is a big part of health.
Hi, CDreamer. I know what Marmite is but I'm not sure I know what a Marmite question is. Does it have something to do with people either loving or hating something, which in this case would be statins? Thank you.
Spot on. Yes, Marmite is strong in the 'other' flavour "umami" and very much a love/hate thing. Other makes are available, but Brits in Australia and NZ import the proper stuff instead of buying Vegemite or what passes for Marmite there. It's made from the ends of brewing processes.
The natural response to what you said is one solution doesn't fit all.Cholesterol is a case in point.
The body generates 80% of our cholesterol.
Yet many older people don't have a problem.
While others, like me, who have always had a healthy lifestyle and diet, have a problem that is controlled by medicines.
I also have CVD (two stents) and yet I'm alive because of collateral arteries (probably due to my excessive running ( 20-55 yo timeframe, which probably caused my AFib).
Like you, I am a positive person who is a believer in quality of life versus longevity.
I believe it is up to each of us to find the right approach for me (by researching over and over again and experimenting).
I am fortunate to have five specialist I can see when I want.
Lively discussions ensue at times but I ensure they are aware of all my decisions and concerns and medicine alternatives.
My current focus is nerve damage in lower body (caused by excessive squash, tennis and running) which I am pursuing via a MILD procedure with several specialists.
My reseatch - my potential solution to my quality of life pursuit.
Rambling but bottom line is do the research and be determined.
The only tripe I see here is the use of disrespectful and unkind words such as “tripe” to describe a forum member’s thoughtful and intelligent comments!
Tripe: a complete source of protein. Taken in moderation has zero side effects unlike most pharmaceuticals. So, useful? Way more than your contribution DennisVA
You' ve made a good case why statins are not for you -- given your current medical conditions and lack of cardiac risk factors, including no family history.
I just hope that those who have more risk factors will not be dissuaded from the benefits, which I don't think is your intention, however it could read that way, as some of the alternate approaches you mention are simply not strong enough for many who have multiple risk factors, or who actually have been diagnosed with CAD.
And yes, while the brain needs some fat, statins reduce harmful cholesterol and inflammation that can lead to atherosclerosis, including in brain arteries, lowering stroke risk and improving vascular health.
I find it sad that statins often becomes a Marmite (love it or hate it) issue. It really should be an is it for me, or is it not for me issue .
I'm sure they are overprescribed for some yet under prescribed for others. I hope everyone does their own due diligence on this very important issue. I have, and in my case, statins made the most sense for me.
It’s the incentives to GPs to prescribe which I feel is just plain wrong.
My understanding that the incentives are paid by the government for the purpose of ensuring best medical practices, only in cases where patients meet the guidelines. Something similar to ensure that afib patients above a certain CHADS score are on anticoagulants. But interesting, no one seems to object to that.
If only, that’s not how it seems to work in practices here, mainly because GP practices tend to not get enough money per patient to operate without taking up incentives such as vaccine programmes and health checks to prescribe drugs to patients just because they are out of ‘official’ ranges. NHS pay GP practices £168/per patient on their list/per year, I bet that is less than you in the US would pay for one appointment.
GPs cannot financially exist without the subsidiary payments for health checks which can account for up to 80% of their income. To my knowledge I do not believe assessing risk for anticoagulation comes into this category but the whole QOF system is so complex and considered none cost effective that it is thought to be broken.
A lot of the the health checks are basically tick box exercises to be able to get the money. I submit to the ‘statin’ conversation on an annual basis so that my practice can claim the points - we all agree it’s a bit of a farce as it seems to completely discount clinical judgement. Thankfully my GP agrees with me that even though my lipids are over the official limit, statins would probably be more harmful than helpful. One size does not fit all.
Locum doctor very well learned offered me another working as good as but not a statin.............
Anyone else on this?
Take this to prevent that in our lives gets to the stage of CHOICE, EVALUATION, RESEARCH and from others who experienced fors and against.
I lost a dear friend in January and it all stemmed from missing her anti-coagulants. Because she had visitors from across the world and had run out. She also got COVID when disabled the 'jabbers' didn't get back to her with a new way to have the mid year one. I had offered to take her wherever in her town but it ended up on deaf ears.
I'll stick to getting all my other prescriptions on time.
Everyone for himself/herself in live but if you are disabled a special effort to do this is so paramount that others need to step in.
Have you heard the latest on supplement of FISH OIL? That will show us how up to date you are?
Would have been much worse if I hadn't been on statins?;
Very possible. Also, the statin dose may not have been optimized. For those with CAD, optimal LDL targets are now as low as 0.78 mmol/L, which in most cases require a very high dose statin plus an injectible PCSK9 inhibitor like Repatha. Particularly if you have a family history of high cholesterol in addition to the CAD and/orblood markers such as elevated lipo(a) or C-Reactive protein.
In your case, you were lucky that you grew collateral circulation, but now it's not the time to stop OMT ((optimal medical treatment) but to double down.
Find the best preventative cardiologist you can and follow their advice and try not to be swayed by internet opinions, be it mine or others.
0.78 is low isn’t it. While I believe it , do you have a link or extract so I can show my GP as I am on low dose. My cholesterol is only 2.7 but ldl is maybe 1.3 and Hdl 1.1
Admin does not allow links. But maybe Google "PCSK9 inhibitor, CAD, LDL targets". Remember, these very low targets are for a select groups, incld those with significant CAD or intolerant to statins.
Something missed by almost all cholesterol assessments is the level of a cholesterol-like molecule called Lipoprotein(a), or Lp(a) for short. Any cholesterol assessment missing this is fundamentally flawed, in my opinion based on traumatic personal experience.
I was a marginal statin candidate (prior to my dissection) and agreed with my doc not to take them. However, in 2017 I had a massive aortic dissection including a PAU, Penetrating Atherosclerotic Ulcer, which probably initiated the aortic tear. I also needed a CABG and a stent. During follow-up meds reviews on cholesterol, the Consultant tested my Lp(a) level and it turned out to be a whopping 205 (where the 'of concern' level is above 30!), and he confirmed some association between Lp(a) and aortic problems, mostly with the valve. My extreme Lp(a) level and my PAU and coronaries narrowing were almost certainly linked.
Lp(a) is not amenable to normal statin type meds, the approach is basically get your cholesterol figs down as much as possible and hope you've reduced the overall risk.
High Lp(a) levels can be hereditary. You only need to measure it once in your life, by conventional wisdom.
I'm not sure how you'd get an Lp(a) figure done, or if many doctors are even aware it should be. You might find this paper of use, and could show to your GP. pubmed.ncbi.nlm.nih.gov/378... The full version is free to download.
Note the wording "Numerous epidemiological, clinical and in vitro studies showed a strong association between increased Lp(a) and atherosclerotic cardiovascular disease (ASCVD), calcific aortic valve disease/aortic stenosis (CAVD/AS)..." and in the paper itself "each 50 nmol/L (23 mg/dL) increase in Lp(a) was associated with an elevated risk of incidence of atrial fibrillation by 3%". (I also had AF from age 40.)
You are extremely lucky to have survived an aortic dissection along with everything else! Someone up there is looking after you and thank goodness for modern medicine. Hope you stay well now
In the US, Lipo(a) is also underutilized, however more and more enlightened cardiologists are starting to order it. Fortunately, many of us can order our tests directly without a doctors rx. The Lipo (a) test can be ordered in many states for $49 with results emailed to us directly in 3 days.
There are also several ongoing trials for drugs to lower 80% it or more. One such drug, Pelecarsen, will hopefully be out in 2005. Currently, PCSK9 inhibitors, csn lower Lipo(a) 30%.
There's also a possibility that the supplement NAC, n-Acetyl Cysteine, reduces Lp(a). The literature is contradictory and is inconsistent in terms of dosage and absence of assurance that the product given hadn't oxidised, so without properly understood and enlightened trials, who really knows? I've seen papers that say "no effect" and ones where NAC was used to reduce Lp(a) before other measurements were taken, i.e. there was an integral assumption that it did work to reduce Lp(a). It is a pretty safe supplement though.
Of course other than safety, the big question with these trial drugs, is will a reduction in lp(a) result in fewer CAD events, or is it simply a marker. Again, hopefully we will know more next year.
Haven't seen strong evidence that NAC, n-Acetyl Cysteine, reduces lp(a). But if it has a good safety profile, I suppose easy enough to find out on an individual basis. You can go first
Would have been much worse if I hadn't been on statins?; statins are actually not effective; any other ideas?
Jafib
I have persistent afib, aortic stenosis, and a bicuspid valve, very similar to you. So I did a cursory check which you may also want to do.
Statins reduce the chance of blockage, not necessarily fully eliminate. Other medications can affect the effectiveness of statins. Family genes can also play a part as mentioned above.
Your doctor has prescribed statins for good reason with a bicuspid valve.
Can you direct me to the data/article you read that indicates statins are effective? I now have an Inspiris Resilia valve so no more bicuspid valve for me.
Did you have the Covid injections? Unfortunately, for some, they are known to cause clotting.
You might like to research online, oral Nattokinase and / or Serrapeptase. In high doses these two enzymes are known to dissolve blood clots and arterial plaque. They need to be taken on an empty stomach or they'll be used up digesting food. Also, look into the Keto diet and its benefits and check out Dr Berg on YouTube.
I am being badgered by my surgery to take steroids because my cholesterol level is quite high, a total of 5.3 but my triglyceride level is low 0.8 .
I eat a near perfect diet being a vegetarian/ organic vegetables and fruit /low dairy/ lots of virgin olive oil and flax seed /everything homemade . I am pretty sure a year of steroids starting with a high dose of 40mg is the cause of my problems.
I really can't cope with anymore horrible side effects but am tempted to give steroids a try .
I don't understand why you are being "badgered" by your Surgery. My level is 6.1 and no "badgers" have been threatened in my case. I expect it's the "badgering" and induced worry that is raising your inflammation and your cholesterol level. And your diet is better than mine too. I wouldn't accept it.
Hi Ozziebob, thank you for your reply . Perhaps you have high levels of 'good' cholesterol but that is unusual. I have 3.1 of bad (NHL)2.2 of good (HDL) cholesterol.
I say 'badgering' because I get frequent text messages suggesting I start taking statins. No 'human' discusses it with me or the fact my triglyceride level is low and the high cholesterol level may have been caused by high doses of the steroid prednisolone .
I have been taking the steroids on the advice of a consultant to prevent loss of sight because I had temporal arteritis.
Unless you are an 'emergency patient' contact with my GP surgery is by email which is triaged to gauge importance there is no access to human discussion. I can discuss steroids with the pharmacy but that is not the same as a GP.
Thanks for explaining the steroid situation re your temporal arteritis. I can only hope you are one of those patients for whom this treatment resolves your symptoms.🙏
Can you recontact your consultant re the dose of the steroid and your difficulties? In the meantime talking with your local pharmacist might be helpful?
And actually my HDL at 1.3 is way lower than yours. I cannot imagine your cholesterol level is the most important concern you have at the moment.
I wonder if taking to a Cardiac nurse at BHF on their free phone line might help in giving you some of the discussion you are seeking?
I found these posts really helpful, thankyou. After a stroke last November and in follow ups my cardiologist said I did not need to take statins, after blood tests and checking my diet. During a recent GP assessment she insisted I needed to and has prescribed 40mg daily. I was wondering why she has always been so insistent, now I understand more thanks to C Dreamers post.
Sounds like you've never been diagnosed with CAD. If you were, maybe you would list the "pro's" of statins (including saving your life) and not just the "con's". As to "Low dose statin does the same job as high doses of statin" -- simply not true if your case dictates a higher dose.
I just wanted to thank Jafib for asking the question, and for all of you who have shared your knowledge, experience and thoughts on this topic. I’m in the situation of being strongly advised to take statins by every GP/ medic I see (due to family history, as well as high LDL cholesterol despite excellent diet) … except my own GP who has some reservations. So this conversation is really interesting and helpful, thank you all Jx
just to add, my PCP recommended a CT cardiac calcium scan … CAC … because of a hesitancy on my part to take stains due to increased LDL. I received a score of zero (at age 70) which shocked her and my cardiologist which usually indicates low risk of clogged arteries, though in some cases may not apply . Aside from LDL my signs are good, hi HDL, low triglycerides, BP low, no diabetes, no smoking, exercise regularly, etc. I think this simple scan can be very useful for decision making regarding statins
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Jx 
Statins and CoQ10
Just out of Interest.
statins/coq10/methotrexate
Statins
What comes first? |Silent AFib
