Re: Stenting

daybova@xxxxxxxxxxx wrote in news:1153776266.571632.214250
@i3g2000cwc.googlegroups.com:

My blood results are excellent. I am doing aerobics for collateral
formations, there are no angina symptoms, and my LVEF is > 50%. My
Nuclear stress test is Negative (Good). The sensitivity (ability of the
Nuclear stress test to detect disease) is about 85% and the specificity
(the ability of the test to detect normals) is 85-90%. Thus there is
the possibility of a "false positive" that is the test says there is
disease when there in fact is no disease or a "false negative" where
the test says there is no disease and there is disease present.
Currently at age of 68, I am doing 10.9 METS aerobics on trademill for
30 minutes. In addition, I am doing many other semi-aerobic exercises
for 1 hour.

I am very confused particularly in view of the following FOUR reasons
as to why some cardiologists are wanting/recommending me to have
stents,

1. Stents are not proven to increase life expectancy. Currently long
term mortality data comparing stents to CABG are limited and short term
data indicate heterogeneity between trial findings and no difference in
mortality.
In comparison to stenting, CABG is associated with reduced events by
55% and with reduced revascularizations by approximately 80% in
multivassel disease and in single vassel disease. There is no
difference in mortality apparent between interventions to date.
2. Stenting runs risk of scar tissue. The greatest disadvantage of
angioplasty is that scar tissue can develop at the site of the
treatment. This problem occurs within 6 months in approximately 30% of
patients.
3. Stents are permanant part of heart, They are not reversible
4. Stents may require restenting in 6 months.


My options right now are
1. Stenting voluntarily now even if no angina symptoms. Go to hospital
now. But again face options 2A, 2B, 2C below
2A.Do nothing now and then later Wait for angina attack or other
indicative symptom and then if I am not dead, get stents
2B Do nothing now and then if I am not dead, go to hospital to have
emergency angina/bypass surgery or
2C Do nothing now and then later have sudden death at home


If I am going to face options 2A, 2B, 2C even after stenting then what
is advantage of stenting now, particularly when it is not proven that
it increases life expectancy.

Please post your comments/experience. Thanks


I don't know where you came up with your statistics regarding a stress test
but they seem a bit optimistic. Do a google search for "stress test false
positive" and see what hospitals are saying about false positives and false
negatives*.

To me, the stress test, nuclear or otherwise is a bull*** excuse to
collect money from the insurance company. The stats regarding false
negatives and false positives are, quite frankly, horrible. My doc wanted
me to have one recently but after I had one a few years ago I SWORE I would
not have another. I will not take a stress test ever again.

Oh yes, and for those that have not taken a stress test, read about what
you have to do to "prepare" for the nuclear stress test and about the test
itself. Running you to exhaustion is just exactly that, EXHAUSTION. I am
willing to bet that well over 95% of the people who take stress test have
never run to exhaustion. The chemical induced stress test makes you wonder
if your heart is going to explode. And for what? Up to 30% false
positives and up to 50% false negatives*. If I had performance stats like
that at work I would be fired after 2-3 days.

Stents are good if you need one. It beats some of the alternatives. Once
you get a stent installed you will be on Plavix or Ticlid or some other
"thinner" the rest of your life**. That is in addition to aspirin. Did
the Docs tell you that? Did they also tell you that Plavix can have some
unliveable side effects?

PS. Read about and talk to some people that have had a CABG. This is not
what I would call a easy procedure to recover from. The rule of thumb is
one month of recovery for every hour you are under general anesthetic.
Read about the risk of long term cognitive disfunction associated with a
CABG.

Google is your friend.

Peace

* http://www.ocalaregional.com/CustomPage.asp?guidCustomContentID=%
7B1A49A907-555E-4FF8-ACFE-15C3B5104AE8%7D

** That is what my cardio told me.
.