Interventional Cardiology Expert Forum
Alternatives to Another Stent?
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Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina , atrial fibrillation , cardiac catheterization , cardiomyopathy , drug abuse & cardiac disease, echocardiography , heart failure , hypertension & heart disease , lipid management , minorities and heart disease, peripheral vascular disease prevention, valvular heart disease , women’s heart health, and the warning signs of a heart attack.

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Alternatives to Another Stent?

Background:  Mid 50s.  Male.   Never smoked.   High level of fitness.   Careful diet.  Low weight (never overweight). "Normal" stress levels.  Always normal blood pressure, low resting pulse rate of 45 (runner/walker for 25 years), and moderate (220) cholesterol--but very high LDL.  "Mild" heart attack in mid-'06.  Four blocked arteries; one calcified; other three opened with drug-eluting stents.   Embraced almost fat-free diet and doctor-prescribed drug treatment.  Cholesterol now about 130.   LDL down from 160 to under 60.  HDL up.  Low Triglycerides.  

Despite an extreme low-fat, low-cholesterol diet, aggressive exercise (at least 45 minutes of intense aerobics six days a week and some weight training) and adherence to medications, found out I have another blocked artery.   Advised that I need another stent.

My concern is that somehow my body chemistry is corrupted and, despite the intelligent and caring efforts of my cariologist and my rigid regimen, I'm going to have recurring problems.   Looking for advice.   Should I agree to a 4th implantation of a stent or are there alternatives to consider?  My doctor says that bi-pass is not necessary and would not mitigate the need for future stents.   With my relatively young age and high level of fitness, I would agree to bipass if I thought it to be a more permanent solution.   In the alternative, I would embrace a different drug therapy if someone can advise me of something that has worked in similar circumstances.  I take Aspirin, Niaspan, Crestor, Coreg, and Plavix.  Any guidance would be very much appreciated.
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You are doing the right things and clearly your program can produce the right results.  You should consider having the fourth stent and continue your present program.  You have had this problem  (CAD) slowing building for many years--and the treatment takes time to work also.
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