Lesion Progression

Dear Physicians at CCHC,
Background - Appoximately 3 1/2 years ago I had a one vessel angioplasty(without a stent) performed on my LAD because of a 95% blockage.  Since then I have had annual thallium stress tests all with normal and similar results.  My daily medications consist of aspirin(325mg), tenormin(50mg), vasotec(20mg), pravachol(10mg), hydrochlorothiazide(25mg), and imdur(10mg).  I am also taking 1mg of folic acid and 50mcg of vitamin B-12 daily. I am also jogging(12 minutes/mile) for 30 minutes each day.  The medications and exercise maintain my resting heart rate at 50, my blood pressure at approximately 110/70 and my homocysteine level at about 8.
Questions - Are yearly thallium stress tests sufficient to check the progression of the lesion?  In general, what percentage of blockage would have to be present to be detected by thallium stress test?  In general, with the proper changes in lifestyle how long can one expect a successful angioplasty to last?
Congratulations on your Blue Ribbon Award!
Thanks - Cody

[CCF-M.D.-CRC]

Dear Cody,

It sounds like you are on a good medical and lifestyle program and this will significantly decrease your risk of another heart attack.  Yearly thallium tests are commonly used to follow coronary artery disease after angioplasty and some doctors will even check less frequently if there are no clinical problems. The percentage of stenosis detected on thallium is usually in the 70-100% range.  With medications and lifestyle changes you may never need another angioplasty!  Thanks for the congratulation.

[Mike123]

It seems to me that stents are doing more harm than good.  What do you think?

[John Mc]

You might be on to something about stents being more harm than good. I personally have had 4 angioplasties and 5 stents put in. One inside of another! and all have failed. I finally had to have bypass done to correct the problem. As far as I'm concerned my arteries are now a scrap metal bin. But I do feel great since the surgery.

John