Interventional Cardiology Expert Forum
Changing statin and other regimens
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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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Changing statin and other regimens

Hi
MY BACKRGROUND (AGE 56, HEIGHT 168 CM, 88 KILOS.
2002 Angioplasty for 70 percent blockage using catheritization (arm, Dr. Saito in Japan). No stent.
2006 no restenosis. 2008 Did CT scan  radioactive dye and also no restenosis.
Age: 56--> Regimen: Lipitor 5 mg, baby aspirin, fish oil (about 3-4 grams).take 4 grams EPA or EPA/DHA depending on Japanese prescription, one glass red wine most evenings, olive or canola mainly
I also take some drugs for prior ulcer-proton pump inhibitor, gastric lining coating, and asthma (singulair and flotide)

Salt- Have always used very little (for japan, which is high anyway and most people get at least 10 g a day in Japan

Last results in August:
Triglycerides 89 (lowest),  HDL  51 (used to be 68), LDL  86 (lowest yet), CK protein  290 (where normal is 40-180). Cardiol. said before ok if no pain.
ALT 29.8 where normal is -25, AST--28 where normal is 10- 30)

Blood pressure varies.  Before 127/75. Now it varies from 139/86 to 120/85 to errors (when I get nervous the machine in the gym gives odd results).  But in general, the bottom figure seems a bit higher whereas the top figure fluctuates. Could be I am nervous when measuring....  My weight down  5-8 pounds SINCE August (when blood test was done). Another was done yesterday.

QUESTIONS
Are my regiimens good? Another forum Dr. said CO-Q 10 300 mg is good if taking statins, but I have NO Pain.  I do not see any research that says this has any merit. He also said Niacin helps trigs, but my trigs seem fine,  Would one normally want to try Niacin if fish oil regimen gives these results?

MOST TROUBLING QUESTION
Asthma Dr. said  I should go from Lipitor 5 mg to Crestor (dosage not yet mentioned) after 1 more blood test. Long time ago, cardiologist said no need to change when another MD suggested. (I think Crestor has big marketing push). Is there any advantage to Crestor given my figures?


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Your LDL goal should be <70 and if you are only on 5 mg of Lipitor the first thing I would do is to increase the Lipitor dose to 40 mg daily.  Crestor is stronger mg for mg as compared to Lipitor but there is no data that suggests it is better.
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Thank you.  A bit confused as now 5 mg is my dose, and you said 40? Not 10????????  Maybe Japanese doses are lower?????? And already at 40 my CK is way over normal at 291.  So wouldn't that risk problems with muscle pain.  Also, you did not mention about the CoQ 10, which is disappointing.
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