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Avatar universal

carvedilol and MI ?

59 yo white male.  1 year post MI with two stents in my RCA.   I am active and with high a normal BMI of 25  No problem walking a fast mile or with light exercise.  My LVEF was 50% right after MI and 45%  2 months later.  due for another echo in 2 months.   my lipids are under control -  LDL < 70 and TC < 140, with or without the 10 mg pravastatin I am prescribed as I eat mostly a quality plant based diet, low in fats and simple carbs..

My question has to do with drugs.  I will come off effient eventually and stay on a low dose aspirin.  No problem.    I would like to minimize the coreg and statin.   The diet I am on is helpful for Nitric oxide and for endothelial health as well as providing some level natural ACE inhibition, and platelet aggregation inhibition, and is high in natural anti-oxidants.

So, what will staying on 6.25 mg coreg and 10 mg pravastatin do for me in the long run?  I would like to try going back to 3 mg coreg for a bit if my echo is good and drop  pravastatin all together.   and then assess everything after 6 months or so.   I understand that some studies show long term benefit for patients like me but these are people on normal diets (much higher in saturated fats and much lower in many nutrients) and who are likely not as active as I am.   I would like to be drug free to the extent possible and would like to understand what markers are important to a cardiologist in setting a drug regime.

thank you
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63984 tn?1385437939
You have been given wonderful advice, in my opinion.  
I had my first heart attack at age 60 and received my first stents in the RCA.  Like you, I started exercising and could walk a mile in military time and lost enough weight that my BMI is normal, and my cholesterol level was almost identical to yours.  I quit taking carvedilol and my statin as I thought I had my heart problems knocked, and soon afterwards, even though my cholesterol, diabetes and weight was normal, I had to have six more stents, a pacemaker, and eventually bypass surgery.  Today at age 72 I'm back taking the drugs, but I also have Congestive Heart Failure, and believe me, taking carvedilol and Plavix was much easier.  I have to sleep in a chair because my lungs fill with water. I made a huge mistake by stopping the drugs.

The dose of carvedilol  you are taking is small, but it is a powerful drug.  Usually you will be increased to 50 mg a day, that is what I take now.  It won't be fun, but carvedilol can remodel your heart.  The doctor gave you wonderful advice, in my opinion.  Keep us informed.
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Avatar universal
MEDICAL PROFESSIONAL
Post MI we have great data for both beta blockers and statins. For carvedilol post MI with an abnormal left ventricular ejection fraction the benefits are both for mortality and to help the heart remodel to a more normal shape and function. The minimum dose shown to be of true benefit is the 6.25 mg, and I would even suggest increasing your dose instead of decreasing it. For statins, they too decrease mortality and need for a repeat stenting in the post MI period. This seems to hold true in addition to their cholesterol lowering affects.
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