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British Heart Foundation
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Life after stent

I am 37 yrs old and had a stent to my heart.left coronary artary.how long will it work.

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I'm guessing your stenting is recent and you haven't had a follow up chat with your cardiologist?

I asked mine the same thing, and the answer was quite sobering: about 10 years. It's a foreign object in your body, even after it's "settled". It doesn't break down or anything (it's titanium, I think?), but your artery will eventually just grow over it. It's probably one of the reasons why you need to change your lifestyle and diet, so that when that stent becomes obsolete one day, the effects are minimised.

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Thanks.I changed my life style and diet.also doing exercise.

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It all depends on whether it gets blocked - there are people who have had the original stents for over 30 years with no problems. It is also possible to put a stent inside a stent...... but you are doing the right thing in changing your diet, exercising and taking meds - all increases the chance of the stent lasting.

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Thanks for the advice

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Have you any thoughts on what it is about your life style that's meant you needed stents?

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I don’t think there is an answer - tablets and technology are changing all the time, with respect the ‘10 year’ quote it can only ever reflect what has gone before. There has been progress and advances in medical knowledge and our own understanding and ownership of what we can do to help ourselves. A lady I met at cardiac rehab was 23 years post a serious heart attack and two stents. I’m sure there are many other examples out there

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I have posted previously about two people over forty years post bypass and HA respectively, and I also know someone over 20 years post stents. Stop worrying and if prescribed statins take them as they also reduce irritation and a stent may cause irritation.

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Don't take this the wrong way. Dr. Aseem Malhotra asserts that the evidence shows that stents do not add years to life, but they do potentially improve quality.

I agree that dietary changes are necessary, the most effective being to lower the glycaemic load of what you eat to less than 60 GL per day; 45 if you wish to lose weight.

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You might enjoy this article

ncbi.nlm.nih.gov/pmc/articl...

I saw Dr Aseem Malhotra on the Nortern line the other day unfortunately not enough time to discuss his ideas with him!

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I find all that hard to digest. I had a 95% blocked stent (100% first time they checked). With 2 stents my quality of life has massively improved. But surely my life expectancy is also improved - I wouldn’t have lasted very long as I was. The 10 year thing has seriously knocked me backwards - I’ll spend 8 of those working and get 2 years of my pension before checking out. Life plan was to be a healthy fit 80 year old - swimming, travelling and playing golf. Dont like the new reality.

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A 78 year old lady in my rehab group was offered a bypass or stents. She asked how long the stents would last and was told 20 years. She said they’ll do and had them fitted instead of the bypass. I think 98 is not a bad prognosis. Don’t worry. Worrying won’t help. After 10 years the geniuses will have invented something better and you can have that. 👍

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I expect you will enjoy many years of your retirement.

Lifestyle changes and medication are also very important in preventing progression of heart disease.

My husband had his stent inserted for a nearly 10 years ago and he just gets on with life.

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Thanks - needed that this am. I’ve cut out the low quality food and I’m back exercising. Suddenly this am realised that I might not see my kids in adulthood. Even 10 years doesn’t seem a lot at 47. Got to get my head straight. Bad morning.

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Hi Dave I’m 44, 42 when had MI and 5 stents in all 3 (and a young child). I have to say that I am pretty fit in comparison to my peers (heart aside!). I am back to running a couple of miles and cycling with relative ease and at a fair pace. I just wanted to point out that the study being pointed out- is not really a thorough or fair study on which to predict life expectancy. Age of study participants and type of stent are the main differences to what you and I are working with. As someone else points out, we are all different, but surveying Veterans who mostly had the old bare metal stents ( “a Morris minor to our rolls Royce” as my rehab nurse pointed out) is a million miles away from where we are. Ok a stent, MIGHT only last ten years - but we know the signs this time and chances are we will be able to react again next time and get intervention. I thought I was tired from having a toddler and a stressful job - I know now there is a difference. BUT there is no reason to believe we can’t prolong this by decades by exercising and lifestyle management. If you are up for it, we can do a fun run together in 2040 - what do you say?

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Made me laugh at least! I’ve never been one for running unless there’s a ball involved. I’m in for 2040.

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If it ago 10 years,how was it feel.can work hard?and can spend a normal life?

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My husband's family is greatly affected by heart disease. He also lives with Atrial Fibrillation.

Sometimes life bowls us a curved ball.

His attitude is not to worry about something that may not happen.

He works full time, eats a Mediterranean diet, exercises and most importantly stopped smoking and keeps his weight down.

He manages his stress as well as possible. He does dip into various meditation apps which is something that doesn't come naturally to him but does help.

He takes the medication he has been prescribed and we enjoy our time together and with our family and friends. He attends an annual medical check up provided by his employer.

As a family we are open and honest with each other and talk about the challenges we all face in life. Humour and laughter are a great tonic too.

He has hobbies one of which is to brew a very tasty New England style IPA.

Life is for living. Seize the day as they say....

Good luck, maintaining the health of both your mind and body are key with the love and support of those you care about most around you.

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That's rubbish, without my stent I would have died 2 years ago!

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Stents when used to open up coronary arteries when they are totally blocked causing the most serious type of heart attack a STEMI ST elevated myocardial infarction are as you say life saving.

However there is some debate when stents are used instead of medication to treat stable angina.

The article I posted above discusses this very issue.

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I think a lot depends on the studies you read as results vary. I read the article you attached and it quotes 5 year survival for proximal LAD stenting at 83%, however I read a study showing 5 year cardiac mortality survival at 96% following proximal LAD stenting.

Angina becomes symptomatic at around 70% stenosis or greater. A successful stenting resulting in TIMI flow grade 3 will reduce this stenosis to approx 10%.

I didn't have a heart attack but I feel so much better and safer walking around with a 10% narrowing than a 70% one.

Surely this has to improve your life expectancy?

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Yes I agree quality of life is very important and often underestimated.

The studies are suggesting that whilst quality of life is improved there is no firm evidence to suggest that in the long term they impact on mortality.

I have heard very experienced Interventional Cardiologists confirm this view.

I live with vasospastic angina it can not be treated by stents only medication. I live with a great deal of pain especially at night and at rest. I have no permanent narrowing of my coronary arteries. My myocardial ischaemia is caused by spasms in my microvessels and coronary arteries. My coronary flow reserve is reduced

I am at risk of a heart attack, stroke or heart failure too.

Heart disease is complex!

By your reasoning because my quality of life is so affected by my chronic and acute pain episodes I'll be shuffling off my mortal coil sooner rather than later!

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Where in my post have I stated that you will be dying soon. I am not talking about quality of life, i am talking about legth of life. you are simply refusing to listen to my argument which I will say again

Because ischematic coronary heart disease is typically associated with progressive luminal narrowing it is obvious that a mortality benefit exists because it takes a damn sight longer for a 10% narrowing to cause problems than a 70% one!

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This forum quite often tries to have discussion that both inform and at times explore difficult subjects.

Over all we all try to do this with respect often we come to the point when we decide to agree to disagree. I feel we have reached this point.

I am listening. I just interpret the research differently and with respect that is my privilege.

Here is my final comment.

It is not just about how the blockage looks it is how well the blood flows through the blood vessels.

Cardiologists are now using techniques during angiograms to determine how well the blood flows through the arteries before inserting stents rather than by ' eye '

Known as the 'oculo-stenotic reflex.'

ptca.org/ivus/FFR.html

Sometimes what may seem obvious turns out not to be so.

Ultimately stents along with lifestyle changes and medication are all important to improve length of life when you live with Cardiovascular disease.

It is not just the quanity of the days lived but their quality.

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As previously stated you do not suffer from ischematic heart disease. I had a stent fitted guided by FFR so i believe unfortunately that i have more experience than you. A lot of people on these forums are scared and looking for hope for their long term future.

Consistently posting negative reviews about stents being a waste of time when in a lot of cases this is the only treatment offered to people is not helpul.

There are already a few posts on hear from people who are now worried.

If that was your aim then congratulations but you are not helping us.

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Hopefully no one is dying soon!

It is stressful to read articles that do not put a particularly positive outlook on the treatment you have received. I share Fergus's frustration at the results of this linked study - it's enough to ruin a stented person's day. That being said, I also have to agree with Fergus in that: surely the very state of having a blood vessel widened has to reduce the possibility of a fatal MI, no?

I was exercising through my angina on a daily basis for a few months thinking it was indigestion. Eventually after several investigations (Stress test, CT scan, nuclear stress/rest test) ending with the angiogram, a stent was inserted. My cardiologist said I could have popped my clogs at any time during my heavy exercise periods such was the blockage. Now I have been told to exercise because I am safe with the much increased bloodflow. An increased life expectancy, no?

Also my father had a heart attack when he was 63 - losing 20% of heart muscle - and underwent quadruple bypass some 22 years ago. Since then he has had 2 stents inserted and he goes in for more complex stent procedures (2 more) on 23rd of this month. His existing stents are not reclogged and the looming procedure relates to new blockages. I can't imagine that with two currently blocked blood vessels, along with those still functioning stents keeping two others open, that he would still be on his feet today. Did the original 2 stents not increase his life expectancy?

I'm not saying that this particular study is bogus, only that its findings are surprising to me - and clearly Fergus, too. I would argue that stents plus medicine plus exercise plus better lifestyle should all combine together to elongate life expectancy.

Let's bloody well hope so!!

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If you read my answers I also agree that stents play an important role with lifestyle and medication in the treatment of coronary artery disease.

Stents used appropriately in particular to treat a high risk ST elevation myocardial infarction do save lives and importantly prevent permanent damage to the heart muscle and hopefully prevent heart failure.

Stents certainly relieve the symptoms of angina however there has been an ongoing debate about whether they increase mortality for sometime.

I asked a very prominent interventional Cardiologist involved in research at the BHF his views and he used the term ' ocular stenosis reflex' to describe the over use of stents for the treatment of stable angina.

There are many procedures and treatments in medicine that are carried without a good evidence base.

What is required is an honest and open discussion with those who provide your care and long term outlooks.

Please don't shoot the messenger

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Funny when I had my heart attack last June, and the doctor doing the Angiogram said my arteries were clear as a free-flowing highway. I said to him I’m a type 1 diabetic, non smoker, no alcohol, eat lots of fish some chicken, greens, garlic, earl grey tea only and generally avoid junk, So he didn’t need to stent any arteries. But had a Pacemaker fitted a month later though. So it seems, my heart prob is electrical rather than it being caked out with gunged up arteries.

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At the end of the day we are all learning about the heart. There are, I think, no right or wrong answers. We are all different, we react differently to different things. The human body is a wonderful thing.

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I had my first stent when I was 34 and when i asked the surgeon how long would it last , he considered his response before replying about 20 years and it was 20 years almost to the week before I had my second one. I am now 58 and have a total of six. If I am honest this is probably a result of diet and lifestyle.

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I’ve seen and know a few beer & wheat belly dude’s who drink like fish consume the worst possible diet, yet, they don’t have any heart issues whatsoever so they’ve said.

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One of these had been telling me for years they are "healthy obese" so they were shocked when a pre-op for minor surgery showed up a problem with their ECG. Their operation is on hold and further cardio tests have been lined up.

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Healthy obese 🤣🤣🤣🤣 so funny.

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My Cardiologist just said ‘well it’s taken 43 years of which you have been smoking for 30 of them to clog the arteries, so there is no reason that it won’t be another 40 before they clog again’. Not sure I total believed him, but you have to admire the confidence he has in his work 🤣.

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Because I had bypass surgery most of the research I've looked at has been focussed on that rather than on stents. However, there is also research for bypass surgery that's similar to the stent research linked to, namely that the benefit is palliative (quality of life) rather than mortality (length of life).

academic.oup.com/eurheartj/...

I've a number of technical questions about these pieces of research (I wish for example they defined the composition of their control groups more clearly), however the main fact I keep reminding myself is that I'm not the general population referred to in the research.

I'm me, unique in every respect. And so, of course, are you!

That's important, because it means our response to our atherosclorosis can be different to that of the general population, and therefore our outcome can also be different.

I'm pretty unimpressed with how most people deal with their heart disease. In the recovery ward after the bypass operation I saw one of my fellow patients struggle outside for a cigarette. And even on the cardio rehab course (which surely represents a group with above average motivation) most people were tinkering with lifestyle changes rather than fully embracing them. I suspect part of the problem is that doctors are so eager to give words of encouragement and not put people off by setting the bar too high, that they end up giving only "good news" messages. What gets lost in those overly optimistic statements is the fact that we have an incurable, progressive disease that, like the Terminator, will never stop trying to kill us! So unless we do things differently we will just keep getting worse.

Is our medication sufficiently powerful to keep us out of trouble? Unfortunately the evidence doesn't inspire much confidence. The only medications that appears to have proven mortality benefits are statins and aspirins, and not by a huge amount either. All the other drugs we take are helpful, but I cannot find any really solid evidence that says we can rely on them to deliver the decades of additional life that we want.

That leaves lifestyle.

Personally I'm diving into an extraordinary suite of lifestyle changes, in the hope that will deliver extraordinary results. I'm completing the full 150 minutes of recommended aerobic exercise per week (excluding warm up and cool down time), I'm layering additional resistance training on top of that. I'm committed to a Mediterranean diet and I've chosen to give that a serious low carb twist. I'm losing weight and I want to keep going with that, also introducing intermittent fasting into my regime. I gave up smoking many years ago but unfortunately switched my addiction to nicotine lozenges, but I've now quit those too (that by the way was far harder than quitting smoking). I'm lucky in that my GP has a very enlightened approach to heart disease and uses quarterly blood tests rather than annual to monitor my status, but I'm augmenting that with private testing and monitoring to bring my care up to global gold standards.

I could go on but you get the message. I'm implementing lifestyle changes so different from the populations in the research that I shouldn't be bound by their results.

I hope I'm doing enough, I guess only time will tell.

Finally, going back to the OP's point. As a relative youngster of 37, you have correspondingly more years of potential life ahead of you. That increases the possibility that you'll benefit from future medical breakthroughs, but it also means you'll have to work that much harder to stay healthy for forty years or more. I'd suggest that for you a root and branch review of your lifestyle is even more important than for older heart disease sufferers. Good luck!

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Good points well made !

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(First post long time lurking)

Still worry every day about my HA and one stent three years ago. (If it was a HA no one ever explained anything to me?) Now im even more worried, possibly only ten years if stents even help at all.

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Worrying won't help Jack, focus instead on what lifestyle changes you are making.

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Oh I've totally changed my life style. Lost 4.5 stone. On the usual medication after HA, everything looking good, BP cholesterol level etc but the whole event is never really off my mind.

Sorry for hijacking the post I'll shut up haha. 😊

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I believe that after smoking the most important risk factor that you can change is your weight. So congratulations on your epic weight loss, that's an amazing achievement! Are you now in the safe zone of your waist measurement being half or less than your height measurement?

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First time I've heard this so just measured, yes I am. 👍

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Silly question 😂😁 But if I'm 6ft 1 then what should my waist measurement be?

I've lost nearly 5inches off my waist

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So you’re 73” tall, which means your waist measurement needs to be below 36 1/2”.

By the way, using trouser size measurements isn’t very reliable, manufacturers flatter us with optimistic sizing, so use a tape measure.

A 5” loss is a brilliant result!

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Thank you very much Chappy chap

I'm currently sitting at 34inches but I do have a tendency to bloat when I have a bit of bread etc..I'm trying so hard to keep carbs (bad carbs out of my system) and I was doing so well straight after my procedure last year. But now on occasions since I've been back at work and I'm rushing here and there I grab the guilty snack! It's only just started happening and I immediately feel I've let myself down afterwards.And I've noticed that I'm just starting to get that tiny little stomach appearing again that I worked hard to get rid of.

So at the moment I think I'm fluctuating with my 34inch waste.

But then saying that all my gym joggers fall to my ankles these days😂😃 So I'm obviously still alot better than I was.

Can I ask your opinion on Weight training. I've gone back to it because when I lost weight I lost 7lbs of muscle in total.So I'm trying to stay lean but build muscle but straight after I'm getting nasty angina attacks that I believe like Milkfairy that it's Coronary artery spasm. I ride and I don't do alot of swimming now because of the water pressure. But my job involves one hell of alot of walking and lifting every day so I'm obviously getting my steps in lol.But I want to continue weights and for my mental state not just physically. Sometimes I think I'm pushing too hard especially after a hard day at work then to the gym then a bloody nasty angina .I had one last night.came home all positive after a workout out then bang I was off my feet and in bed for an hour or so! I don't want it to dictate my quality of life but feel this condition is doing exactly that.

Any thoughts?

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Firstly, congratulations on your waist measurement, 6'1" with a 34" waist is a great place to be. It means there's hardly any chance that you have "visceral fat", that's the blanket of fat deep inside your abdomen that wraps around your organs. Visceral fat is toxic, it's a shortcut to type 2 diabetes.

Personally I do believe in weight training (or rather in "resistance" training as weights aren't strictly necessary, you could be doing press-ups, dips, etc) alongside aerobic training.

However, one of the key messages on the cardio rehab course was the critical importance of warming up. A proper 15 minute warm up (where your pulse will probably be in the high 80's or low 90's), covering all the major muscle groups, dilates the arteries and dramatically reduces the chances of angina like symptoms.

When we were teenagers we could explode into activity with no preparation, once we're older and especially with atherosclerosis, unless we thoroughly warm up we'll pay a price. The nurses on the cardio rehab course advised warming up even before heavy housework or gardening, let alone for resistance training or for a physical job where you're lifting and shifting.

Finally, I'm with you on bread. I absolutely love bread and most other carbs, but I also tend to bloat after eating them. It's also really hard to be away from home and eat satisfyingly without relying on rubbish carbs.

It's tough, I wish I knew an easy solution, but I haven't found one. It's just about saying no to that sausage roll or that sandwich when your body is screaming "gimme"! What's also a bit depressing is that waging war on carbs seems to involve endlessly trading off tasty stuff for less tasty stuff, so an apple instead of a banana, or brussel sprouts instead of sweet corn.

But at the end of the day I love life more than I love pitta bread (although some times it's a close run thing!) so by and large I do the right thing.

Good luck!

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So after that fairly somber discussion about stents etc I best look into my funeral arrangements sooner rather than later! Because I have coronary heart disease after a stent procedure to unblock a 90%blockage in LAD And now it looks like I'm heading down Milkfairys road with either vasospastic Angina or coronary artery spasm or both so I'm pretty much buggered aren't I people.So it seems even if I stick to a good diet and exercise I'm bloody doomed with all I have going on.

Best make the most of my time with my kids after reading some of your posts.

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Rob we are going to out live everyone😁

Well I might get shot first as the messenger of unwelcome knowledge 😳

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The LIPID heart trial was a secondary prevention trial of statins in patients who were diabetic or insulin resistant and who all had pre existing heart disease. Some 30% had already had stents or bypass surgery.

Patients were grouped by age and in the under 55's cardiac mortality was only 10% after 18 years.

In other words for the people diagnosed at a young age there is a lot of hope for the future as this trial was completed in 2003 and there are now better drugs and stents available.

Yes some people do not survive a long time, some will get hit by a bus, we just don't know but if you modify all the risk factors you can along with the medication available I believe certainly for people in their 50s or younger you can be optimistic about the next 15 or 20 years.

Being anything other than that does not help anyway!

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I was diagnosed with familial hypolypodeamia 7 years ago was put on statins changed my diet. But still had a heart attack and 3 stents last year. I was told it wouldn’t matter what I ate I would of still had my heart attack but would probably of died. So now I just carry on with the healthy diet but if I want something nice to eat on occasion I will. If I didn’t have the stents I wouldn’t be here now

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Hi Thushara,

I think you are doing all you can to keep yourself healthy, and understand how frightening and worrying to have to have a stent at only 37. I had 2 stents fitted 3 years ago when I was 59. I’ve watched my diet and exercised regularly before and since. I have inherited high cholesterol, so I’m just stuck with statins , and beta blockers for life, but I’m ok with that.

Every now and then, I get a little worry panic on, about how long I’ve got left, I then push it away and concentrate on how great I feel.

As soon as I had the stents I felt so much better, hadn’t realised how bad I had been! I am lighter and fitter, than I was 20 years ago, when I thought I was fit!

If I hadn’t had stents, I would probably not be here today, so I am so grateful for that!

Have always lived my life to the full and will continue to do so, the cardiac nurse at rehab, assured me I was fixed, If I ever felt that feeling of being short of breath again, I would know next time and get sorted out again!

Sorry for the long post...it’s my first....but just want to say, live your life, enjoy your family, try not to worry. With medical advances, all this could be a thing of the past in the next few years!

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"Newer Drug-Coated Stents Prolong Life Expectancy According to UAlbany-NYU Study

ALBANY, N.Y. (April 16, 2015) -- Newer drug-coated stents have similar life expectancy rates as traditional bypass surgery, according to a clinical registry study led by University at Albany Distinguished Professor Emeritus Edward Hannan and cardiologists at NYU Langone Medical Center."

albany.edu/news/59318.php

This article explains the mechanism as to why older "bare-metal" stent might pose some potential vascular adverse effects.

"In the longer term, however, early generation stents have seemed prone to react with heart vessels in a way that promotes inflammation, scar tissue growth and the eventual re-closing of arteries. In addition, early generation stents were more prone to develop blood clots inside the stent, even many years after stent implantation, resulting in death or heart attack."

If you still have one of these "early generation stents", did your Cardiologist inform you these risks?

Did they tell you pros and cons of "percutaneous coronary intervention, or PCI i.e. stents vs bypass operation?

I previously commented that my family is riddled with rare disorders; I have seen medical articles written by "eminent professors" and doctors. 80-90% of them made swift conclusions, which are simply not helping patients or are simply not true, except rare professors, who had true compassion and commitments to help patients. There are so many eminent doctors worldwide, but there are very few of them that truly put patients at the heart of their practice.

It's important to look out for the forefront of these medical practices, internationally.

If an article is full of "doom and gloom" "bad news to ruin your day!"etc, do not bother wasting your time reading these. Always, worth fighting against negativity and pessimism.

Conclusion: Newer drug-coated stents have similar life expectancy rates as traditional bypass surgery, according to a clinical registry study led by UAlbany's Edward Hannan and cardiologists at NYU.

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I was back at work in 6 weeks few hours takes time to build up

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Riding bicycle,running is suitable to stent patient?

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