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Avatar universal

heart attack/sudden death risk

Hi! There are plenty of sites on the net where you can calculate your risk of a heart attack or sudden death depending on age, lipid profile and all the other usual suspects. What I cannot find anywhere, however, is the risk in someone who has CAD already. I am 58 (almost 59), not overweight, BP is low at 115/75, non smoker. My LDL used to be high at over 160 but my HDL has always been very high as well (around 65 - 70). A 45-50% blockage in my LAD was discovered two years ago following first a CT scan and then an angiogram. No stent was put in, as I am completely asymptomatic. I was put on Crestor, gradually increased to 40mg's and I seem to tolerate it well. My LDL is now way down under 80 and my HDL still ok at about 55 or so.

Given the above, what is the annual risk in %? If anyone knows or can refer me to a website, that would be great. I asked a couple of cardiologists and have received two totally different replies....1/1000 (0.1%) and 1 - 2/100 (1.0% - 2%)

Thanks,

George
9 Responses
159619 tn?1538184537
COMMUNITY LEADER
Take a look at this one. It includes a calculation for several forms of CAD;

http://www.riskscore.org.uk/

My guess is that your risk is more along the lines of 6 - 8% based on the fact that the low risk number for your age group is about 4 - 5% so your risk would be higher.

Jon
Avatar universal
thanks, will have a peek at the link. Yes, I agree, I also thought it was higher than either cardiologist had suggested (certainly the 0.1 figure was out to lunch!)
Avatar universal
Jon, unfortunately, the website you recommended only lists a prior MI or stroke (as well as cardiomyopathy) but there's nothing about asymptomatic people with single vessel disease. Therefore, my risk comes out as "low" because all my other indicators (BP, lipids, non smoker) are excellent. Thanks anyway!
1756321 tn?1547098925
Homocysteine isn't even taken into account with these risk assessments. O_o

Check out a great book called - The H Factor Solution: Homocysteine, the Best Single Indicator of Whether You Are Likely to Live Long or Die Young by James Braly, Patrick Holford.

"Conventional wisdom uses a mixture of risk factors (sex, blood pressure, cholesterol, ECG, diabetes, smoking) known as the Framingham risk score to predict risk of cardiovascular disease. This study in Holland of several hundred elderly people with no history of cardiovascular disease measured these conventional risk factors, and also potential new indicators namely folic acid, homocysteine, C reactive protein and interleukin 6, over a five year period.

Quoting the study “Classic risk factors did not predict cardiovascular mortality when used in the Framingham risk score. Of the new biomarkers studied, homocysteine had most predictive power. Entering any additional risk factor or combination of factors into the homocysteine prediction model did not increase its discriminative power.” Two thirds of cardiovascular deaths were predicted by a high homocysteine level alone.That’s in comparison to a recent survey that found that 75% of those that had a heart attack didn’t have high cholesterol."

Excerpt from - Homocysteine predicts heart disease risk better than cholesterol, blood pressure or smoking by Patrick Holford.
976897 tn?1379171202
I'm astounded that anyone would want to know their risk factor. To me this adds more unnecessary worry. If you are doing the things recommended by the professionals, such as diet change etc, then why go around thinking "oh my, I'm 80% sure to die in the next few years". I can't emphasise enough that NOBODY KNOWS when your time is up. Knowledge and techniques on intervention grows daily, so such figures are pointless because this is not a static scenario, it's dynamic. I remember in 2007 I was told I was at 90% risk of a very serious heart attack and yet now 5 years on, my arteries are open and I feel great. Having those numbers in my head did nothing but cause fear and depression. There is a risk factor each time we cross the road, however, with common sense we are still here. I prefer to be optimistic and believe in the next decade some incredible break-thru's will present themselves. Just recently I read how skin cells can now be converted into different types of brain cells in mice, soon to go into human trials for stroke victims. So many companies are playing with the blueprint of life that the keys will be unlocked to cure anything.
Avatar universal
Ed34: good response! :-) However, I must emphasize that I don't lose any sleep over this and do not dwell on it. I want to know for two reasons. Number one is simple curiosity. What does this diagnosis mean? How common is it? How much more can I, or should I, do to improve my odds of a healthy life? I don't think it's an unreasonable position. In fact, for every single person with a serious disease such as cancer, the first question is: "Doc, how long do I have?" The second reason is that risk assessment interests me on a purely theoretical level. The risk of being in a plane crash is about one in a million per trip, so I have no issue with flying. The risk of being killed or severely injured in a motorcycle accident when not wearing a helmet (they are not compulsory in Florida) is 1 in 200, which is too high. I have never bought a lottery ticket because it's like throwing money out of the window (chances of winning average 1 in 13 million...you will die in 13 different plane crashes before you win the jackpot, hehe) But I HAVE played blackjack because it's fun and the odds are not bad when you know what you're doing.

Lastly, I'm just a bit surprised that there's nothing on the web that takes atherosclerosis into account when calculating risk.
976897 tn?1379171202
I know where you're coming from, but risk calculations are meaningless to me for one reason. As you say, flying is very low risk for example, but each time I board a plane I wonder which side of the statistical fence I am on. Have I boarded a plane with the crash statistic, or the safe one. I keep spinning the thought "flying is low risk" in my head, but it just pops back saying "ah, but which percentage are you on this plane". It's true, any statistic on risk can't tell you which side of the fence you are on, so I just don't bother.
When I had 5 stents put into my LAD, I was told that due to the hardness of the plaque, the length of the blockage and the fact it was on a curve, there was a 1% chance of my artery being pierced by the catheter and that would almost certainly cause a serious problem. Now, I remember thinking "1%, wow that's nothing, go for it". Within just 2 mins, bang, the catheter went through my artery wall. Luckily he got a stent in there very quickly because the artery would have torn a long way down like it had a zipper.
Rather than looking at general statistics, I personally think it's probably more accurate to look at how ones luck has run in the past few years. If you are one of those (like me) where things tend to go wrong if they possibly can, think twice :)
Avatar universal
What you say makes sense. I guess the default position is that mitigating risk minimizes worry :) Risk will NEVER be zero. You seem to be doing ok, keep it that way. Whereabouts are you located? I had my angiogram done in Canada where doctors are in far less of a hurry to rush in and stent you if you are asymptomatic. Down here in Florida they stent you if they find a hair in your artery :)
976897 tn?1379171202
I'm just outside London. My Left artery was like a 200 year old water pipe, and it took me 2 years to find a good enough plumber to clean it out. Every time I clean out my kettle, I wish I could pour descaler into my arteries :)
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