Diabetes and Angioplasty

Questions and comments about diabetics and angioplasty.

Current Postings (29):

• Bruce, Take it from someone who had a Stent Thrombosis, its better to wait than end up like me with both. I do understand the Arthritis, Because I too suffer every day, No only Rheumatoid, but gout, caused by having too take so much Flurosomide because of the heart damage. I understand taking pain killers are no fun, but its better than the alternative. Wait out At least the 12 months suggested by the FDA and more if possible. You see, I cannot have the surgery for two reasons, the damage done to my heart by the ST and the fact I will have to take Plavix the rest of my life. Good Luck.
Bob Pucket, Snellville, Georgia, USA, May 20, 2007

• I just wanted to follow up from my earlier post [March 9, 2007] regarding my angioplasty in March. All is well. No chest pain, no problems with my surgical site. Full work schedule, I own and/or manage 4 construction type businesses working about 80-90 hrs/wk and planning a trip to Disney with my daughter in 2 weeks. My issue remains my severe arthritis. I spoke to my Cardiologist about going off plavix for this. He discussed this with me, the ramifications, etc. I discussed the ramifications of not doing the surgery soon, mainly pain management and quality of life. Pain management means become addicted to narcotics, quality of life means not doing the things I enjoy, such as the Disney trip which will happen along with a big bottle of pain killers! Final decision rests in my lap. Should I decide that in balance, the risk is worth it he will support my decision and allow me to go off plavix for the surgery. The orthopedic surgeon is willing to do the surgery with a possible modification as yet undetermined to my plavix regimen. Also of note, this surgeon would have put me on plavix after surgery to prevent blood clots afterwards regardless.

My diabetes is under good control, in part to feeling better since surgery. I have 4 months to wait to the six month point that my Cardiologist would like to see happen before stopping the plavix for a few days. At this point I plan to wait that long, even if I should become narcotic dependant. I am grateful for the support of my physicians, the dedication to supporting my pain control needs regardless, and the trust they place in me to make decisions on my own based on all the facts presented to me to evaluate. I think this is truly a situation where the patient and doctors are working as a team toward one common goal. I am grateful to them for their pragmatic and valuable information, and the trust they place in me to weigh the facts against the quality of life issues and support my decisions.

From my cardiologist's point of view I am doing really great, he couldn't be more pleased, and neither can I because when arthritis doesn't slow me down, I can do the most strenuous things (I can run up 20 flights of steps without stopping and feel great at the top) with no symptoms whatsoever.
Bruce Main, Mid Atlantic Nursery, Germantown, Maryland, USA, May 18, 2007

• Nita from kansas, i had three stents placed in both artery and vein back in 2004, as the stents where placed i had chest pain which i was told would go away within twenty mins, this i took at face value, i now know different the chest pain stayed for three years 24/, it was heartburn, chest wall infection, indigestion, virus you name it i had it.after a lot of pestering i had another stent placed and at long last i am now pain free, listen to your body the doctors can only guess what you are feeling if your doctors are anything like the english ones most of them have hearing problems i wish all of you better health good luck with the rest off your lives.
Jack, England, April 10, 2007

• A Note to the Forum Editor: I had my follow up with the interventional Cardiologist that treated me in the hospital- the one that installed the stents. All went well. My regular MD helped me make arrangements with the Pharmaceutical company that makes Plavix, and I was given a three months supply..and, come to find out, my medical card does cover the generic, and I also later found out that the ambulance bill was covered in addition to! ( I've yet to see a bill!) In terms of medication and my heart, I'm doing well, and have even gone on several long walks- that is when the weather has permitted it... I DO have one question,though, is it normal for my chest to still be a little sore? Admittedly, this only happens when my dog wants in my lap, and gets up against my chest to snuggle. (She's an adult dog, and weighs in at 45 lbs. Not exactly a lap dog..but, she's still convinced that she's still as tiny as when she came home five years ago!)
Nita, Wichita, Kansas, USA, March 19, 2007

• Bruce -- thanks so much for your detailed post. We're glad you found value in this Forum and, as for your motivation to post a positive story, we also thank you. As we have noted in other topics, any online Forum such as this can become a "complaint department" and that's not a bad thing. It's a way of surfacing concerns and very real problems. For example, our Forum on allergic reactions to DES is one of the only places on the net where this potential adverse reaction has been publicly raised -- and it caught the attention of researchers who are now enrolling patients from that Forum into a study to find a test and treatment). But it's very important to balance postings of complications, etc. with positive outcomes -- which, by the way, represents the majority of patients. Your advice to others is also excellent. Stay well and stay in touch!
Angioplasty.Org Staff, Angioplasty.Org, March 16, 2007

• Just had a Cordis Cypher DE Stent placed on 3/7/2007. I'm home and couldn't feel better. I am 50, a type 1 diabetic using an insulin pump, and overweight. I take Lyrica for neuropathy, Mobic for arthritis, Humalog in my insulin pump, Toprolol to slow my heart rate. The Toprolol contributes significantly to my hypoglycemic unawareness. I wanted to post to thank all that have posted for their comments, all of them were of great value to me and contributed significantly to my awareness and knowledge.

Up to the day of the angiogram I had no idea I had a problem. In fact I felt I did not have a problem. I did not feel limited in my physical activity. I generally felt fine, my only symptom was a general awareness that something was wrong. Now I can see that was not the case. Symptoms had crept into my life without me being aware. I didn't recognize my discomfort as chest pain. I didn't recognize my slightly swollen ankles each evening as a problem. I thought it was due to coexisting severe arthritis. I didn't notice I was reducing footsteps because I couldn't handle the exertion. I thought it was caused by my arthritis. The few times I wondered that it might be chest pain, I discarded that notion because not always did I have chest pain when I exerted myself. In fact I shoveled snow without chest pain but didn't notice it wiped me out for the remainder of the day.

I visit my endocrinologist regularly and did not feel my diabetic issues were the cause. So often others blamed them as the cause of unwellness. My concern for general unwellness tempted me to visit my cardiologist that over the years I visit every few years or so. He has never felt I had any problems. This time to be sure he ordered tests including an EKG, Stress EKG, Echocardiogram, and a Thallium scan. All normal except of a hint of a possible problem on the Thallium scan. At the suggestion of the Cardiologist, I had an angiogram Wednesday that demonstrated a near total blockage of my LAD just below the point where it begins from the left main. I wanted to contribute a post for everyone that was positive and showed excellent results as one of my concerns of this forum was there was so much posted about results that in many cases were poor that it at first tended to skew my thoughts on such an important matter it began to make me question my own judgment about the necessity of the procedure when balancing the serious problems some of us had had. I reviewed statistics from other sites and spoke to the physician in detail prior to the procedure. Ultimately I had the procedure on schedule and am glad I did. I don't know what the future holds for me, nobody does, but I am happy, feel great, and have a very positive outlook and plan to push forward with life, with modifications in lifestyle to afford better and healthier living and do the things important to me and my family in life. Hopefully this post will be of benefit to someone and help in awareness that not always are the symptoms always obvious, and if not recognized in time the results could be catastrophic. Read all the available posts and be concerned, ask the physicians questions to ease your mind, and move forward with a plan that works for you.
Bruce Main, Mid-Atlantic Nursery, Inc., Germantown, Maryland, USA, March 9, 2007

• Mona -- there are so many variables in what the best course of treatment should be. Among them are the size of the blockage, which artery and where in the artery, numbers of blockages, other factors, such as diabetes. The biggest problem in diabetics is the high rate of restenosis (reblockage) that's been seen. Some studies of drug-eluting stents show significant reduction in this restenosis rate, specifically in diabetics. But these are questions to ask and have answered by your sister's cardiologist (maybe you could accompany her to the appointment). There are risks and benefits from all procedures, so it's best to get as much information about these as possible.
Angioplasty.Org Staff, Angioplasty.Org, February 24, 2007

• My sister is 64 years old and has coronary blockage. She also suffers from diabetes type 2 and high blood pressure. Question is: Is angioplasty recommendable for her? Thank you.
Mona Hanley, London United Kingdom, February 24, 2007

• I have no idea what system was used. Some kind of pump was used for suction . I was told that thrombo suction is used. The suction machine was used 4-5 times. It was a difficult procedure but I was lucky that the Dr who performed is one of expert in India in the field. This forum is great as I am getting lot of information.
K M Bhargava, INDIA, February 22, 2007

• M. Bhargava -- We wonder if your cardiologist was using a device that was just approved in the U.S. for vacuuming out clots, called the AngioJet, made by Possis? As for medications, you really need to discuss these matters with your doctor because adjustments to meds are different for each individual. You are taking perindopril, an ACE inhibitor, and metoprolo, a beta-blocker. Both lower blood pressure -- in your case, it's too low, but again, don't change your dosages without consulting with your MD. Let the Forum know how things work out with BP.
Angioplasty.Org Staff, Angioplasty.Org, February 22, 2007

• Yes have prescribed Clopidogrel 75 mg twice daily along with other drugs. RCA was 100% blocked due to clot which was 15 mm long. The clot was before the stent. Complete clot was removed by suction. The problem now is that my BP have gone low 100/70 while lying and 90/70 after standing as such I am unable to do any physical work. I am advised that it is due to medicine (perindopril erbumile, metoprolol succinate) and will reduce as the drugs are reduced. I am on diet control. I want to know lowering of BP and weakness is normal in case like mine.
K M Bhargava, INDIA, February 22, 2007

• M. Bhargava -- all you can do is reduce your risk factors -- take the meds prescribed by your doctor, who knows your situation better than anyone. Did he/she prescribe clopidogrel or any antiplatelet drugs? Also watch your diet, keep active, obviously no smoking, etc. Was the artery blocked by a blood clot? or was it a reblockage (called restenosis) caused by regrowth of tissue inside the stent?
Angioplasty.Org Staff, Angioplasty.Org, February 20, 2007

• Hello, I had angiography performed last Monday. My RCA was 100% blocked due to blood clot. Fortunately my doctor could remove all the clot and now artery is clear and no new stent implanted. Homocystein level was 19.3 Doc recommend folic acid. I am diabetic too. How to avoid recurrence of such event.
K M Bhargava, INDIA, February 13, 2007

• thanks for your prompt reply. Bio divsyl 3.5 x 13 mm direct stenting of RCA was performed at AIIMS, New Delhi. Our appointment is on Monday with the same Doctor.
K M Bhargava, INDIA, February 3, 2007

• M. Bhargava -- was the original stent in 2000 a bare metal stent? It is certainly possible that the stent may have restenosed (reblocked) -- if so there are several methods for reopening it -- a recent study shows that inserting a drug-eluting stent inside of the reblocked stent is the best method -- this is not currently approved in the U.S. ("on label") but is commonly performed as an "off label" use and, as the recent study showed, has resulted in better outcomes than either plain balloon angioplasty or brachytherapy (radiation). Let us know how you fare.
Angioplasty.Org Staff, Angioplasty.Org, February 3, 2007

• I am 47 years old. I had MI in 2000 and there after one stent was implanted. On 28th I had severe chest pain and was admitted in local cardiac ICU. There is no change in ECG but the blood test indicate possibility of MI. During test it is found that I am diabetic. I would like to know what treatment is there if blockage reoccurred exactly where stent was placed? I have been relieved from local hospital and going to larger hospital for consultation. Through this forum I would like to know of other if any who have gone through the same problem as me.
K M Bhargava, INDIA, February 3, 2007

• Nita -- we wish you luck, but you already had some good luck. You were at a hospital where angioplasty/stenting was done immediately during/after your MI! (This is not always the case.) Angioplasty is the preferred therapy for MI right now and probably saved your heart muscle so that you can make an excellent recovery. Interestingly enough, your cardiologist implanted bare metal stents, not the drug-eluting type. This means you need to take Plavix and aspirin for a shorter period of time -- about 6 weeks. But take them! Aspirin is inexpensive so that shouldn't be a problem. Check with your doctor/hospital. There may be some drug plan for people who cannot afford Plavix ($4/day). Bristol-Myer/Sanofi-Aventis who make Plavix refer people who cannot afford their meds to another website, the Partnership for Prescription Assistance, for possible help. Let the Forum know if this is any benefit to you. As for other costs, like the ambulance, uninsured patients can sometimes negotiate with the hospitals, etc. for a lower fee, often 50%. Good luck and let us know. But please, make sure to take your meds -- they are very important to a healthy recovery.
Angioplasty.Org Staff, Angioplasty.Org, January 28, 2007

• I am a type 2 Diabetic, diagnosed Jan 2004...Had a heart attack just this last week. Went to ER, and was almost immediately taken to the Heart Cath Lab, and had an Angioplasty, in which the attending Cardiologist implanted two Multi-Link Vision Cobalt Chromium Stents in my Right Coronary Artery. I spent a day and a half in CCU, after which, I was transferred to a regular hospital room. I was up and around that same evening! I was released a day and a half later. All and all I feel far better than I did prior to the Angioplasty, however, I have TWO huge concerns- the cost of the Ambulance bill, and how I'm going to obtain the Plavix I was prescribed. (Meaning my insurance/ Medical Card doesn't cover for that particular medication.) Wish me luck!!
Nita, Kansas, USA, January 27, 2007

• Sultana, there are certainly those who might opt for medical therapy (pills) only -- but if your father refuses to stop smoking, any therapy is really not optimized. The number one risk factor for coronary artery disease is smoking. The best thing your father could do is to stop. As for angioplasty, has an angiogram been done so the physicians can see the extent of his disease and decide whether angioplasty or bypass surgery may help?
Angioplasty.Org Staff, Angioplasty.Org, November 21, 2006

• my father is a 67y old, diabetic (takes tablets), He has severe angina pain, can only walk a short distance before his chest and leg pain start. He has been told to undergo the angioplasty surgery. He is very scared and persistently believes this will make him more weaker and possible decrease his life expectancy. He is a smoker and refuses to give up, he has recently lost his sight in left eye due to blocked arteries, he still smokes and doctors are surprised that he has gone on without a heart attack, my father believes he can go on as he has done on medications (tablets). please help i do not know what is the best solution for him, i know there are risks to angioplasties, how will it affect him? i have discussed it with the heart doctors they suggest that my father should accept the surgery and that there are low risks. i am a bit unsure after researching on angioplasty cases. please feedback ASAP- the hospital hAVE a booked bed this week for my father. Thank you.
Sultana, England, UK, November 17, 2006

• my co-father had his second attack on last month. Now he had undergone PTCA and the echo results show that 50% of LVEF and the LV mildy dialated. What type of angioplasty can be suggested for this patient. He is now 50 devoid of any type of diabetic or bP complaint.Now he is under treatment with cardiopril, atocor, clopigrel, metolar, deriphylin
Murukan Ambika Viswanathan, India, June 03, 2005

• I am a diabetic.I underwent angioplasty to remove 2 blockages in my Left Circumflex Vessel, in March 04 (Single Vessel Disease). Since then I have been having a burning sensation on both sides of the chest and back pain, off and on. It subsides at night but slowly builds up during the day. I have been taking Pantaprazole from time to time but have stopped doing so after a week or so. Any possible reasons?
Rajesh, India, July 26, 2004

• I have heard about diabetics who undergone PTCA and affected coronary arteries found to be resternosed after 3 to 4 months.
Sabrina, Singapore, 7 Jul 2000

• I TOO HAVE JUST HAD AN ANGIOPLASTY PERFORMED - 4TH MAY 2000 - WITH A STENT PLACED IN MY RIGHT CORONORY ARTERY. I AM ALSO DIABETIC AND ALSO VERY CONCERNED THAT THIS WAS NT THE CORRECT TREATMENT FOR ME - BUT NO OTHER OPTIONS WERE PRESENTED AS IT WAS AN URGENT CASE. I AM NOW USING THE WEB TO FIND AS MUCH INFORMATION AS POSSIBLE TO ALLOW ME TO MAKE A MORE INFORMED DECISION ABOUT HOW MY TREATMENT SHOULD PROGRESS. I WOULD WELCOME ANY INFORMATION/SUPPORT FROM ANYONE IN A SIMILAR SITUATION.
GLENNIS THOMSON, CUMBERNAULD, SCOTLAND, 28 Jun 2000

• I am facing a plasty possibly with stents. I have diabetes but it is very well controlled with sugars rarely above 110 fasting. Also I lost 65 lbs and blood pressure (with norvasc) is excellent. After nuclear test they said I had some blockage in two arteries but there was no evidence of heart muscle damage. Would the caveats about having this procedure with diabetes apply to me? I'm totally freaked about the whole idea. I was being pre-oped for some leg surgery to free up a nerve that has been causing me incredible pain for 22 years. Worst of all the surgeon who did that one miss set my foot causing the problems I have now. So you can see my fear. Please e-mail I have to have this done in 2 weeks. The persantine test was scary enough. Scared to tears in Colorado
Dan Pollock, Colorado Springs, Colorado, USA, 30 Apr 2000

• Several years ago, studies showed that diabetics don't fare as well with angioplasty as they do with coronary artery bypass surgery (CABG). There are a number of factors involved, but with the advent of stents and new technologies, treatments change, and recommendations must constantly be re-evaluated. If you will look at the description of the EUROCVS meeting held in The Netherlands at the end of January on our Meetings Page you will see that interventions in diabetic patients was a major topic. As with all these procedures, decisions must be made on a case-by-case basis. What might be right for someone else might not be right for you. By all means keep doing research (use many of the links on our site) and discuss your situation with an interventional cardiologist. And let us know how you do.
Angioplasty.Org Staff, PTCA.ORG, March 1, 2000

• Is angioplasty safe for someone with diabetes?
Frederick S. Hahn, San Marcos, California, USA, March 1, 2000

• Hello, Penny. Allow me to suggest that you also post these comments to the internet newsgroups you will find listed on our site, specifically the alt.support.angioplasty and sci.med.cardiology groups.
Angioplasty.Org Staff, PTCA.ORG, December 11, 1999

• Hello, I suffered a heart attack on aug 11th 99 and had a cardiac cath done on Dec. 1. Now my cardiologist wants to do an angioplasty early next year. I have since read that this procedure is not advised for diabetics, which I am. I am obese since childhood, used to smoke and drink. Do neither now. Living in the Caribbean I am concerned about getting the right treatment, even I have been told Barbados has the best Cardiology unit in the Caribbean. I am concerned that I am getting this procedure done and then still face the possibility of a heart attack. Having read some comments in the forum, I would like to hear from someone that has been through it and is in a similar position as me. Thank you so much.
Penny Atkins, Barbados, WEST INDIES, December 11, 1999

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