Re: My Mom - Statin Needed?

Larry wrote: 
Thanks for your help!

So ... you are suggesting that the CT scan of calcium deposits is of limited value in assessment of CAD? I'm guessing that the only real way to know is cardiac cath/angiography? I don't think she needs to be put through that. What would you suggest?

By the way, two recent LDLs for her were 95 and 108 (after the initiation of low-dose statin therapy).

I would just feel a lot better if we could keep her Total Chol below 200, and her LDL at 100 or below. Hence the reason that I asked her to consider just another 2.5mg of Zocor. Your thoughts?

Larry

The total cholesterol isn't a particularly useful marker once you are looking at LDL. When considering goal cholesterol levels on statin therapy you can pretty much ignore tha total cholesterol level.

There is no particular magic to the number 100 mg/dL, and the marginal benefit in people from getting from nearly 100 mg/dL to a little below 100 mg/dL is probably very small. Even if calcium score were considered as proving known CHD (it clearly doesn't do this for the purposes of existing studies and guidelines) the marginal benefit in people treated with a statin with stable CHD for getting from 100 mg/dL to below 80 mg/dL is quite small: there is no decrease in all-cause mortality, and the absolute decrease in cardiovascular events is around 1 to 2 percent over five years.

So this sort of benefit may well not be worth the increased side effects of higher doses of statins.

--
David Rind
drind@xxxxxxxxxxxxxxxxxxxxx

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Relevant Pages

  • Re: My Mom - Statin Needed?
    ... > Larry wrote: ... When considering goal cholesterol levels on statin ... > There is no particular magic to the number 100 mg/dL, ...
    (sci.med.cardiology)
  • Re: My Mom - Statin Needed?
    ... >> Larry wrote: ... When considering goal cholesterol levels on statin ... >> There is no particular magic to the number 100 mg/dL, ...
    (sci.med.cardiology)