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CAD Plaque Regression
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iride6606 posted:
I had an interesting discussion with my father's doctor today. He recently moved here from Phoenix and had to see his new doctor for the first time today. My Father has a history of late onset CAD and had 5 CABG surgery at 78. His new doctor here noticed his old Cardiologist had him on 80 mg of Pravastatin and changed him to 80 mg of Lipitor. I HAD to ask him why.

He told me that based on the recent SATURN trial, his medical network (the largest in the country) has decided to recommend Lipitor in high doses to patients with known CAD. The trial results show that both Lipitor and Crestor showed a regression of arterial plaques. I asked for some reading material and he gave me the link below. Very interesting and good to know!

I have a few issues with SATURN, it was relatively small (1,100 participants) and had a cohort percentage of 29% which can be a bit high. In any case, this is a major revelation.

http://www.medpagetoday.com/MeetingCoverage/AHA/29718
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billh99 responded:
That is interesting.

I was on 40 mg simvastatin and when atorvastatin went generic I ask my cardiologist about switching. He though that it was a good idea, slightly more effective and slightly less side effects.

But it was until this year when it became available on my insurance. So I ask my PCP to switch me and I suggested 20 mg as the studies that I had seen implied that was about the same as 40 mg simvastatin.

So I have only had one test since switching and it was LDL 47, HDL 59 and TC 113. And I only had 2 70% blockages, but one was in the Left main which needed the CABG.

So for me I don't see a need to go to a higher dose.
 
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iride6606 replied to billh99's response:
I guess with single vessel disease an marginal blockages, I would avoid a change as well. If you think about this information, it's a little of 1% for the study period or about .7% per year. As a year becomes 5 and 5 becomes 10, that could be a considerable amount of regression and would be the difference between being symptomatic and not, that's a huge quality of life issue.


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