Microvascular disease - Statin?

[Toffodog]

I had my post heart attack follow up with the cardiologist consultant yesterday and despite having 3 stents inserted and was told that I have microvascular disease. with severe plaque build up on my small arteries that they are too small for stents but everything has been done to relieve the blockages I had back in May. I was informed that although my cholesterol levels were low at 3.8 I unfortunately fall into the hereditary category and I should have been taking statins following my first heart attack in 2018 however the was overlooked by my GP. The consultant informed me that without a statin small arteries will continue to narrow causing parts of my heart to die. I was informed that bypass grafting was not an option should narrowing get worse. I am a 67 year old male and was informed that I have the arteries of a 80-90 year old. I hence to add that I have been prescribed Rosuvastatin and need to take this and try to manage and tolerate the side effects .

Could I please ask if anyone has been diagnosed with Microvascular disease and what type of statin has worked. Following the news I had is creating anxiety as I can’t believe that the only thing preventing things getting worse is a statin and I will have no idea if it’s improving and preventing any further plaque build up.

Thank you

[Lowerfield_no_more]

All statins work in a similar way by acting on the liver to basically produce less cholesterol. They also stabilise existing plaque so it doesn't break off in bits causing blockages. But they do not control any side effects such as angina. However although you have only just started taking a statin (belatedly after your HA in 2018), plaque build up is over many years, so the increase in your build up since you HA will be comparatively small, and so the 'damage' in that period might not be as great as you would imagine. If its any help to you I have been taking max dose statin for six years since my NSTEMI and I had two angiograms one at the time of the HA and one about four years later which showed no change in arterial plaque. So if the same applies to you further build up will be considerably slowed now you are taking the statin which I assume will be max dose as now apparently applies to all post HA. Otherwise I don't know what sort of 'lifestyle' measures you adopt to lower your heart health risk but it might be worthwhile refreshing you memory on that by looking through the BHF webpages. Finally statins sometimes come with their own side effects which affect <10% of users,so if you feel that you are affected you will need to talk to the GP about switching to another statin or, if you prove to be statin intolerant as applies to some, other forms of lipid managing medication.

[Toffodog in reply to Lowerfield_no_more]

Thank you for your response. The information you have provided is really useful to know that there are other alternatives to statins if I have some sort of intolerance to them.

[mjames1]

I was diagnosed with severe CAD recently had multiple stents placed. I was never tested for microvascular disease, but always that possibility.

At least in the United States, those with stents and/or microvascular disease are treated with OMT ( optimal medical therapy) where statins are the cornerstone, Not just to reduce LDL cholesterol, but also for their anti-inflammatory and stabilizing properties.

The primary goal is to get LDL (bad)cholesterol below 1.8, but newer and more aggressive goals a1.4 or even lower. To get that low, PCSK9 inhibitors are used in conjunction with statins. That is was what I was told to do..

In addition, we are put on dual platelet therapy therapy for around a year after the stenting and then baby aspirin for life. Other drugs for may include ace inhibitors snd calcium channel blockers.

Jim

[Hidden]

Hi 4 years admitted to hospital had 3 stents and now been told the same as yourself. Microvascular disease. I was taken off my first statin due to side effects and put on Rosuvastatin 5mg by GP. When I spoke to my cardiologist and mentioned the changes he said it was the best statin out there and was very happy for me to continue. So being sensible what I eat I'm still here. I take it you also have your daily 75mg Asprin which is also a life saver. You just need to worry about taking your meds and the rest is magic.🤓❤

[Toffodog in reply to Hidden]

Awe thank you for your lovely message, I too was informed that Rosuvastatin was the best statin so as you say as long as I’m taking the aspirin ( clopidogrel in my case) and the statin I’m doing g everything possible to prevent the plaque getting worse and just need to carry on with life, I hope you continue to stay healthy and angina free .

[Hidden]

🤗❤