LAD 95% blockage Stent or Meds

[cwcardio]

6 weeks ago I had a cardiac cath after failed echo stress test. 95% blockage found in LAD. Comment on findings is 95% mid after D. Other arteries were okay.
My question is, should I get a stent or continue to treat with medications. Can I reverse the blockage with low fat diet. My age is 43.  

After trying medications for past 6 weeks , my Cardiologist recommends a stent because I am still having occasional chest pains a couple of days per week. Sometimes no pain for a week. Pain is not too bad but usually occurs in evening after being outside for a few minutes in cold weather. I am still able to walk/jog on treadmill for 30 minutes per day with no problems.

Currently on norvasc 2.5 mg,, Coreg 20mg, Renexa 500mg, Crestor 10 , Plavix 75mg
and isosorbide 30mg

10 weeks ago Total cholesterol was 263 and LDA was 193. Thru vegan diet and crestor, and exercise , Total is now 121 and LDA = 70

[ed34]

He will survive the treatment, but I don't know enough details to comment on long term prognosis. To know he has 2 blocked main arteries suggests to me that he has grown collateral vessels which should mean he will be fine.

[across9]

my dad has 100% blockage of 2 main arteries and 95% percent blockage to LAD. What is his prognosis if he gets a stent?Will he make it out alive?

[j1george]

Currently, I am nearly 47 year old male.  I have also had a 100% blocked LAD for almost two and a half years, yet my initial blockage caused a heart attack.  My LAD was stented and then a month later, discovered to be reblocked and the surrounding tissue not viable.   Therefore, no restenting or bypass was deemed to be feasible. My LV ejection fraction hovers between upper 20s% and lower 40s%, depending on the measurement.  Additionally, sometimes I suffer from various chest pain.  I try to exercise 20-30 minutes daily, and as Ken mentioned hope for some angiosentesis.. without suffering from heart enlargement.  As a back-up I am hoping that maybe stem cell treatments may become an option that may assist me.

[aundy28570]

I have a complete blockage in my LAD. No previous heart attack but, Yes, I have 100%. So a complete blockage wont necessarily kill you. Luckily mine happened over time and the other 2 arteries are fine and branched to the left. Odd but happens. Had it been caught sooner when at 95% they could have put in a stent!!!! Usually at 100% a stent is not done especially if the dr's dont know how long its been that way. Now I am on medication therapy and after couple of months I go for another stress test. If things are going well most likely will continue meds and go for regular checkups to moniter the other arteries. If the meds dont help like they should then I may have bypass surgery. Basically its waiting to see what meds do and having a good cardiologist!

[warrenf]

an aside; In 2003 my LAD closed completely but EECP continues to keep my heart functioning normal. warrenf

[warrenf]

After a second bypass to my LAD failed, a stent was placed and then radiated to control growth in the stent. Mild angina continued and my cardiologist prescribed EECP treatments. After the treatments the angina went away and did not come back for nearly 12 months. Since then I have repeated the EECP treatments every 12 to 15 months whenever the angina came back. I have now repeated the series of treatments 6 times and after each series I have been able to resume my life with few restrictions[other than diet]. I am 84 and remain very active.

[cwcardio]

Thanks to all for responding. This is a great site.
I forgot to mention that I am also on baby asprin along with the Plavix.

My HDL is now 37, I misspelled above LDL (not LDA) is now 70, down from 193

[kenkeith]

It is not healthy on heart tissues to subject the lack of oxygen to heart cells causing angina.  If meds don't relieve angina then it may be necessary for a stent implant (different opinions whether to implant bare metal and DES [drug eluding stent]...DES may cause clots up to a year or more).

But medication should  be able to dilate coronary vessels enough to avoid a deficiency and pain.  I have a totally blocked LAD and I take 10mg of isosorbide before a treadmil and weight resistant training 3X a week.  Sometimes I just rely on nitro (immediate relief from angina) and no isosorbide (slow acting nitrate).  I'm going on 4 years post a chf event.

Your lipid profile is very good.  Mine is 128 for chol, LDL is 58, HDL 57.  What is your HDL?  The ratio of LDL/HDL is a metric for consideration.  My doc said the HDL sweeps away LDL which is the leading cause for occlusion.  Stay tuned for reversing a blockage or prevention.

The 100% blockage of my LAD has developed colateral vessels and angiogenesis to help overcome the blockage and provide blood/oxygen to the deficit area.. Why are you on Plavix and not aspirin?

[Sweetwaterguy]

   I can relate what my cardio told me a few weeks back:  I have developing blockages--40-70% on two arteries.  This was found by a 64 slice CT scan.  These have not affected my active lifestyle, although occasionally when climbing stairs a little too fast I can be a little short of breath.  
  (I am fortunate to have the benefit of four cardiologists because members of their group travel to my rural community once per week for consultation)
   Each said research studies suggests stents do not improve longevity,although during emergency situations--heart attacks, etc., stents are life savers.  They suggest managing my issue with medication--statins and aspirin.  I do not yet need blood pressure meds.  They also told me that iff I start  to experience chest pain or the blockages affect my lifestyle and activity, I should consider a stent.  
  So the short answer is that a stent might help you live better, but there is no evidence it will help you live longer.  
  At 95% blocked and your doc suggests you would benefit from a stent, I would go for it, given the information you have given us.  

[jim62]

Far as I know, there is no way to reverse blockages.  As much as some would like to believe that they can, it just hasn't been proven.  The stent idea would be the minimum treatment that I'd consider.  May well do better to do a bypass.  But, you doc undoubtedly knows what he's doing.  The LAD is not an artery to be messing around with.  A total blockage can make you dead real quick (and for a long, long time).

Those cholesterol numbers are really good, although I'm beginning to wonder if low numbers is REALLY beneficial as far as CAD is concerned.  (A la Vytorin)