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gina375 posted:
I'm a 64-yr-old woman with CAD; I have three stents. One attempt failed, and my LAD cannot be stented or used in a bypass because it's so narrow and crooked. My most recent stent was put in May 2013. I got some unstable angina in early December and the cardiologist insisted I get an angiogram. He found no blockages. I think it happened because of an exercise I was doing, but who knows. It's gotten better and I only get a sharp attack when I overexert. I'm not doing much, though; no energy and some days I get angina if I just walk across the room. My question is: If I get unstable angina again, and they've pretty much said there's not much they can do, should I even bother to call the doc or go to the hospital? I know it's kind of a strange question, but if I'm going to die from this thing I'd so much rather do it at home. Second question is, he put me on Protonix, and I'm on Plavix. He says it's safe. Any feedback on that? Thank you very, very much. Gina
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cardiostarusa1 responded:
Hi:

......"he put me on Protonix, and I'm on Plavix. He says it's safe......".

FDA Reminder

Pantoprazole (Protonix) may be an alternative PPI for consideration. It is a WEAK inhibitor of CYP2C19 and has LESS EFFECT on the pharmacological activity of Plavix....

http://www.fda.gov/drugs/drugsafety/ucm231161.htm


"I have three stents. One attempt failed, and my LAD cannot be stented or used in a bypass because it's so narrow and crooked."

......"and they've pretty much said there's not much they can do".


In general-only here, and beyond drug-therapy (even the angina drug Ranexa), if/when common procedures, first time or re-do, such as angioplasty, with or without stents, or coronary artery bypass graft (CABG) surgey are not deemed feasible, as applicable to the patient, there may/can be other options, that includes non-invasive EECP, laser-based TMR and gene therapy/transfer.

FDA approved non-invasive Enhanced External Counterpulsation (EECP) treatments.

Are You a Candidate for EECP Therapy?

http://www.eecp.com

Surgical-based transmyocardial revascularization (TMR, FDA approved).

Holmium:YAG laser

http://www.cardiogenesis.com

Growing your own so-called "bio-bypass" (collateral vessels) around blockages in the heart, and in the legs
It's known as gene therapy/gene transfer, which has been in experimental phases for quite some time now.
.
As reported, over the last 20 years, gene therapy has moved from pre-clinical animal investigations (animal models) to human clinical studies for many diseases ranging from single gene disorders, to much more complex, multi-factorial, multi-conditional diseases such as dreaded cancer and cardiovascular disorders.

Readers Digest Online - February 2008

An experimental treatment is giving desperately ill heart patients a new lease on life.

A process called angiogenesis. The experimental procedure had shown great promise in two German studies, and the FDA had approved the launch of the first American clinical trial.

The technique involves injecting the heart with a protein called fibroblast growth factor 1 (FGF-1).

"The protein is like a seed that causes new vessels to sprout, creating a network of capillaries and small arteries."
FGF-1 occurs naturally in the body.

http://www.readersdigest.com.au/heart-hope


Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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Good to know, for the primary and secondary prevention of heart attack and brain attack

Epidemiologic studies (EDS) have revealed risk factors (encompasses some new, novel or emerging) for atherosclerosis, typically affecting the carotid, coronary and peripheral arteries, which includes age, gender, genetics (gene deletion, malfunction or mutation) , diabetes, smoking (includes second and thirdhand), inactivity, obesity (a global epidemic, "globesity"), high blood pressure (hypertension), Low HDL (now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).

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The hospital/medical center you choose can make a difference...a critical difference. Choose wisely!

Credentials, Experience, Research

U.S. News & World Report

Best Hospitals: Heart & Heart Surgery

http://health.usnews.com/best-hospitals/rankings/heart-and-heart-surgery


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James Beckerman, MD, FACC responded:
If you are experiencing symptoms suggestive of unstable angina - i.e. symptoms at rest, that do not go away with nitroglycerin, or that are coming on more frequently or with less activity than is typical for you, I do recommend that you seek medical attention.


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