Plaque in the left anterior descending artery

[Tryingtohelpmum]

Hello,

My mother has very recently been diagnosed with plaque in the left anterior descending artery, she is only 64, doesn’t smoke and walks every day.

I am desperately looking for some help or advice with regards to treatments, options, surgery possibilities or a consultant recommendation in London or anywhere to be honest. She is currently on 80mg of statins to help to ‘coat’ the plaque and prevent it from bursting. The fact that it could ‘burst’ at any moment is the most terrifying part and any help, advice or reassurance would be so very gratefully received.

Thank you in advance 🙏🏻

[MichaelJH Heart Star]

Hello and welcome to the forum! The way forward depends on the percentage blocked, symptoms (e. g. angina and/or breathless) and her general health. Below 50% it is generally lifestyle changes and medication. Above lifestyle, stenting or bypass. I had a bypass last year for an 85% blocked LAD and three other arteries over 70%.

[Ianc2 in reply to MichaelJH]

Very informative. Thanks for the information.

[Tryingtohelpmum in reply to MichaelJH]

Thank you for the reply Michael.

[CocoChannel]

Depends how much plaque as Michael JH says and how much narrowing. Out of curiosity, how was this plaque seen?

I have soft plaque in my LAD, but the narrowing is only 10 to 20%. This was seen on a private heart scan (a 64-slice CT). There is, of course, the very small risk that this plaque could rupture and clot, but the important thing for me is to keep active and watch the cholesterol to reduce/slow the build up of further plaque.

[Ader42]

As others have implied soft plaque is more of a danger of rupture than older harder calcified plaque from my understanding.

How did she get the plaque diagnosed? CT scan or angiogram?

What statin is she on? I’ve not heard of statins “coating plaque”, their typical usage is to reduce cholesterol by impacting the livers ability to make it. Then again I’ve only researched the statin I’m on.

There have been reports and studies of soft plaque reversal if the patients cholesterol gets low enough.

I too am on 80mg, I’m 51 and have 50-75% plaque in two arteries. I was told I wouldn’t even get symptoms of angina until I have over 90% blockage. If my two arteries that have 50-75% plaque had been bad enough they would have put stents in them when they put 3 in my LAD as an emergency procedure last month.

Lifestyle changes such as diet may be needed?

[MichaelJH Heart Star in reply to Ader42]

Besides lowering cholesterol statins also stabilise plaque and reduce irritation often a precursor to plaque. This is why if someone decides to stop statins a low level maintenance dose, e. g. 10mg Atorvastatin, may be recommended.

[Ader42]

Yeah the stabilisation is primarily a result of the cholesterol lowering.

Effectively softer/unstable plaque becomes harder/more stable plaque that contains more calcium(hard) and less cholesterol(soft). Similarly the anti-inflammatory effect is also a result of the lipid changes. No “coating of plaque”.