posted by Susan Sweat, Douglasville, Georgia, USA, January 28, 2000
Please advise the pro's and con's of angioplasty and bypass surgery if there is a 99% blockage of an artery?

• We are in Japan. My husband is in the Navy. He had chest pains and was sent to an internal doctor. They did a stress test and found he had blockage in the heart. He was then sent to a Japanese heart doctor. They did a dye test and found out his main lower descending lefty artery was 99% blocked. The next day they did an angioplasty with a stent. They tell us there is a 20% chance the stent could renarrow in the next 6 months. The Japanese doctor told him to exercise. His angioplasty was on 1-25-00 and he is now walking 60 minutes a day. We will go back to the States for 6 months in a few days. Can you tell me what else we can do to lower the risk of the stent renarrowing? My husband has a low cholesterol level of 138. He is not diabetic, does not smoke or drink. He is not overweight and he does not have high blood pressure. The only thing is his father died of a heart attack at 44. How can this only be hereditary. My husband has always checked his cholesterol and has exercised.
Julie Baker, Sasebo, JAPAN, February 22, 2000
• Julie, it sounds as if your husband has done all the right things. Unfortunately, much as we would like to think that we have complete control over our bodies, there is this thing called genetics. David Letterman was just joking about this on TV last night. He ran 6 miles the day before he had to have emergency quintuple bypass surgery. His cholesterol was low, etc. but like your husband, his father died of a heart attack at a relatively young age. Sounds like your husband received excellent care so far (there are many great interventional cardiologists in Japan). I would suggest making contact with an interventionalist near to where you will be living in the U.S., just in case. The renarrowing (or restenosis as it is known) usually occurs in 20-30% of cases, but this varies widely, depending on many factors. I would suggest not worrying, but being prepared if things don't feel right. Lowering risk factors is the best thing one can do, and it sounds as if you've done that.
Forum Editor, PTCA.ORG, February 22, 2000

The cholesterol level alone is NOT a factor implicated in the cause of heart disease. Many people have heart disease with very low cholesterol levels. What is important is knowing the ldl, hdl, lpa, homocysteine and cholesterol level and the associated ratios between them. For example the cholesterol to hdl ratio should be less than 4 for a very low risk of heart disease. If diet cannot reduce the lipid levels then drugs are needed. It's good to have low ldl (<100 with heart disease) and low cholesterol (<150 with heart disease). It's good to have high hdh (>50 with heart disease) The statins lower cholesterol and ldl levels. Niacin (Niaspan) raises the hdl. Homocysteine is lowered indirectly with folic acid (1000 mg). There is nothing yet known to lower lpa. Anyway...these are some of the facts. It's a shame that the media is always a decade or two behind what is current. The idea that cholesterol is the sole cause of heart disease is obsolete. And a sense genetics is the cause of everything when actually alot of times it's genetics with ignorance.
Orhan Kaunis, , New York, New York, USA, 11 May 2000

Hello and congratulations on your website. I am an eye surgeon and have 2 family members suffering from coronary artery disease. One, 55y male with 99%block in rt.coronary, 40% in LAD & 50% inl.circumflex.known hypertensive, not diabetic; Two, 60y male with c.o.p.d., 90%block in rt.coronary & 40% in Lad. Kindly advise
dr.parul m. sharma, ram manohar lohia hospital, new delhi, INDIA, 1 Sep 2001

Julie, I am 43 and have no risk factors play competitive soccer, golf and love to surf but last week ended up in hospital with the same artery as your husband 100% blocked. It was stented and I am now recovering. I may have had six months of stress at work but didnt think anything of it. Has your husband fully recovered and is he now able to exercise strenuously? I am keen to get back into a normal healthy routine albiet with a very strict low fat diet.
Derek Swanborough, Australia, 14 Sep 2000

• Dear Derek, I am 53 and have an absolutely active life in swimming a 50 metres pool, 20 laps nonstop for 3 days a week and if I am not doing that, I would be in the gym for an hour of workout and in the practicing range with 100 hits of golf balls. I am curious as to what kind of stress you may have been subjected to ?
Dax Tan, gec, Malaysia, 5 May 2002


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