Instant heart disease reversal

17. October 2007 William Davis (16)

What if reversal of heart disease--regression of coronary atherosclerotic plaque--were achievable instantly? Just add water and--voila!!

To my knowledge, it is not--yet. But I sometimes play with this idea in my head. I could imagine that such a program would consist of a few essential elements:

--A fast or semi-fast, or at least a very spare diet, over a period like 10 days to promote net catabolism. It is also supremely anti-inflammatory to restrict calories.

--High-dose vitamin D, e.g., 20,000 units per day of D3 to fully replenish depleted stores and achieve all the metabolism-correcting effects of D3 restoration.

--EPA + DHA at a higher than usual dose with frequent throughout-the-day dosing to encourage replacement of cellular lipid constituents with the more stable omega-3 fraction of fatty acids.

Beyond this, I'm uncertain. What role l-arginine, statins, niacin . . . conjugated linoleic acid? ApoA1 Milano infusions?

This is simply whimsical at this point. I don't know if such an approach would work. But if it did, you might imagine that it would offer an opportunity--for the properly motivated--as an alternative treatment for angina, advanced coronary disease, a means to pull someone back from the brink.

With the insights gained from our slow-but-powerful Track Your Plaque approach, perhaps we will also gain insights into how to accelerate such a process of reversal so that it is achievable in days, rather than months or years.
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Comments (16) -

  • wccaguy

    10/17/2007 3:24:00 PM |

    Dr. Davis,

    You keep making posts about things this newcomer to the Track Your Plaque program is thinking about.

    I was thinking just last night that I would soon make a post at the Track Your Plaque (TYP) forum asking about what a TYP+ Supplement program might look like.

    For people like me who have already experienced cardiac events this would be a huge thing.

    I've now got my blood testing done.  I appreciate your providing feedback yesterday at the forum to my posting my blood test results there.

    I also had a heart scan done even though I know it's of more limited use given my cardiac history and that you basically don't recommend it.  Frankly, I disagree with you a bit on the usefulness of a heart scan with preexisting cardiac events.  I'll explain why later.

    So, I'm ready to go with TYP+ Supplement Program.

    I have some specific supplements in mind that aren't among the current recommended TYP Supplements.  I'll make a note of the ones you mention in this post.  I'd like your feedback on a comprehensive list to try for inclusion in a TYP+ program of supplements.

    I'll make that post to the forum soon now that I know you're thinking about this already.

  • JoeEO

    10/17/2007 11:30:00 PM |

    Dream big my friend!

    I am thinking a resort off the coast of Thailand. You take a month for the treatment. Fly in to a first class medical resort - do your fast while lounging in a tropical paradise - get lots of sun lounging by the pool (aids in Vit D absorption). While you are receiving the various medical and supplement treatments for your heart disease you might want to look into getting a little "touch-up" plastic surgery  or maybe that hip replacement you've been putting off...

    I bet your "instant Heart Disease" treatment, some plastic surgery and a hip replacement in total would still be less money than a cardiac cath and stenting back in the United States!

    I being somewhat facetious in writing this post...but I truly believe that scenario I discribed  
    will be the norm in the next 10 or 15 years - as the rest of the world becomes richer and the regulatory environment in the US and Europe slows cutting edge development i could see some fast developing nation such as Thailand assembling a team of highly skilled Doctors in order become the world leader in treat a particular disease.


    Peace

    Joe E O

  • Dr. Davis

    10/18/2007 12:27:00 AM |

    Hi, Joe--

    Interesting perspective. I hadn't thought of it in those terms. If nothing else, it would make a fascinating experience to watch.

  • vin

    10/19/2007 9:28:00 AM |

    I think that method exists since the fifties and is known as chelation therapy.

    Admittedly the mix, which is often vitamin C and other supplements plus EDTA or something similar, needs to be improved with the current knowledge about amino acids etc. But it could do the job.

    Diet on the other hand is unbeatable. One could spend two weeks in a resort and eat ideal meals to improve health.

  • Dr. Davis

    10/19/2007 2:32:00 PM |

    Sorry, but the chelation in my experience has never worked. I personally have seen several people go through it, usually provided by shady types, with huge rises in heart scan score. Until genuine evidence suggests otherwise, chelation falls in my scam file.

  • wccaguy

    11/15/2007 7:35:00 AM |

    Hi Dr. Davis,

    I have now got my intake of Niacin up to 3g a day using Slo Niacin.  I'm wondering if I shouldn't attempt to get it higher to impact my Lp(a) number.

    I'm 6' tall and at 250 pounds am a "big person".  I'm working on the weight of course.

    I understand there are potential impacts on the liver.

    I have been told and found in the past that Silibinin Plus from LEF and n-acetyl-cysteine work pretty well to keep liver numbers under control.

    What would you think about my taking my niacin dose up to 4g a day (or even potentially higher) if I could keep my liver numbers under control.

    Thanks.

  • Dr. Davis

    11/15/2007 12:07:00 PM |

    I'm a big believer in going slow with niacin. It may take a year or more for it to exert full effects, including reduction of Lp(a). I am generally not in a hurry to raise doses.

    I do favor periodic cycles off niacin, however, especially in people with Lp(a). In my many hundreds of patients with this disorder who take niacin for several years, there is a peculiar creep back up of Lp(a) levels back to the starting values. I believe that periodic "vacations" off niacin are necessary from the start, e.g., one month off every six months. Resume dose gradually and work with your doctor if/when you do this.

    Re: liver protection. I'm only superficially familiar with those agents, and I cannot say specifically whether they spare the liver from niacin effects. Interesting idea, though. Phosphatidylcholine? The liver-sparing effects of this agent are interesting, also. But I know of no specific experience with niacin, unfortunately.

  • wccaguy

    11/15/2007 3:57:00 PM |

    Thanks for the reply Dr. Davis,

    I understand that, because you're not my doctor, you can't give me specific medical advice.

    It's also true that I know of no other doctor who has more of the scientific literature and practical supplement experience than you have.

    First, however, thanks for the tip on periodic Niacin vacations.

    Let me then put another question to you this way...

    I'd like to propose to my doctor the following to get his expert insight but before I do, having your opinion would come in handy.

    Suppose I pumped up my intake of niacin to 5 grams.  After a month of that, I get a liver numbers test.  Then I begin the Silibinin Plus - N-Acetyl-Choline regimen.  Then after another month, I take another liver numbers test.

    Would a scenario like that provide me with useful information for long term Lp(a) treatment without doing permanent damage to my liver?

    Any suggestions for improving the idea?

    One last thought...

    Because Lp(a) is believed to be formed in circulation (per McCormick, Marcovina, et al), it seems to me that continuous availability of niacin in circulation is important.  So, I'm thinking 2 or 3 doses of niacin per day at 1.5g to 2.5g per dose.

    Seems to me that dosing like that would be beneficial to assessing the impact of the Silibinin Plus - N-Acetyl-Cysteine regimen.

    Does that make sense?

    Thanks for all you do!

  • Dr. Davis

    11/15/2007 5:27:00 PM |

    wccaguy--

    I think that it depends on your endpoint.

    If Lp(a)reduction alone is your endpoint, then raising niacin even to 5 g per day is reasonable.

    However, if control of plaque growth is your endpoint, then you might make do with far less, e.g., 2000-3000 mg per day. It can vary enormously. (In fact, I have even seen an occasional person reverse without Lp(a) control, though this is unusual.)

    One warning re: the frequent dosing of niacin. Far more likely to yield liver toxicity than dose is frequency. Taking niacin three times a day as SloNiacin virtually guarantees serious liver toxicity--I would strongly urge you to NOT do this. You are safest with once daily dosing of the SloNiacin preparation.

    Re: liver toxicity gauged by liver function tests. Unfortunately, these are not really good tests for quantitative assessment of liver toxicity; they are rather weak, qualitative tests. So I do not believe you can make much of shifts within the normal range.

  • wccaguy

    11/16/2007 1:47:00 AM |

    Thanks Dr. Davis for the niacin regime tips:

    To sum up.

    1   I will try to get my Slo Niacin dose to 5g per day in a single dose.

    2   I will monitor Lp(a) test scores.

    3   I will take a one month niacin vacation every six months.

    Thanks again.

  • Kiran Sawhney

    7/14/2008 9:01:00 PM |

    Your blog is very informative i must say. I like such dedicated blogs. I too write a blog on fitness and health and life. it is http://dreamfit.blogspot.com
    do stop by sometime.

  • Anonymous

    3/9/2009 10:56:00 AM |

    Dear Dr.Davis,

    I just came across your site for the first time and very much like the content and layout.

    I'm aware that you don't answer personal questions but am not quite sure with what one can post or comment on? I hope my post is considered acceptable and I hope you will take the time to comment briefly.

    I'm in a desperate need to help my mother who had a hearth attack a month ago. She's always had a low blood pressure and considered herself to be very healthy. She is 63 and never been on any medication, no pains or complaints. And all of a sudden-a heart attack! She has had two stents put in and is on several medications-Plavix 75mg, Beloc Zok 25mg, Triatec, Sortis 40mg, Aspirin 100mg and Nexium 40mg.
    I'm aware of the interactions of Plavix and Aspirin-Nexium and am terrified of the complications. She started taking a nattokinease supplement and thought that it will be better if she didn't take the Aspirin-Nexium. However after reading all your comments on natto-i feel this might not be a wise idea. I've been a regular reader of Dr.Mercola.com for many years and ordered a product called Cardioessentials from the site. I must say am not a fan of the statin drug as well but have only insisted on CoQ10 as ubiquinol of 200mg a day.
    She has become more thoughtful of her diet and exercise. I know that thing rarely happen without warnings and am sure she  could have taken a better care of herself. She did gain a bit of weight lately and I know that visceral fat does come with a price on heart health! She is following a diet rich in vegetables and fruits, lean meat and fish, nuts and seeds and low in grains. She takes fish oil, flax oil an olive oil,garlic, green tea, vit C in high doses, vit E and D, ALA, vit B complex, grape seed extract and chlorella. I'm considering L-carnitine, L-arginine, taurine, lutein and NAC.

    Please share a few wise words on this protocol and let me know if there is anything she is missing out on or should not be taking.
    I would greatly appreciate your comment. Thanks in advance,

    Lidija McLaren

  • Treatment for heart disease

    9/27/2010 12:51:28 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • Treatment for heart disease

    9/27/2010 12:52:23 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • blogblog

    10/30/2010 4:00:49 AM |

    This is a routine widely practised in Japanese hospitals for many diseases. They also use an IV glucose solution with electrolytes.

    I am doing exactly what you suggest at the moment.

    Supplements:

    1/2 teaspoon of salt and 1/2 teaspoon of salt substitute (potassium chloride) dissolved in 2L of water. This provides very roughly 2g sodium and 2g potassium/day.

    300mg magnesium and 800mg to prevent cramps.

    A single multivitamin tablet.

    A high potency B group supplement.

    500mg vitamin C.

    5g fish oil.

    After 3 days I have never felt better in my life

  • buy jeans

    11/2/2010 9:27:57 PM |

    This is simply whimsical at this point. I don't know if such an approach would work. But if it did, you might imagine that it would offer an opportunity--for the properly motivated--as an alternative treatment for angina, advanced coronary disease, a means to pull someone back from the brink.

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Be patient with niacin

19. January 2007 William Davis (0)
Mel's HDL started at 37 mg/dl one year ago. Mel had several other abnormal lipoprotein patterns along with his HDL (inc. small LDL and Lp(a)), but HDL was clearly a crucial factor in his panel.

With a heart scan score of 1166, we needed to raise Mel's HDL to the Track Your Plaque target of 60 mg/dl. So Mel started niacin, our number one method to raise HDL, in addition to reducing his exposure to wheat products and other high glycemic index foods; increasing his physical activity; trying to reduce his excess tummy fat; fish oil; dark chocolate (2 oz per day) and red wine (1-2 glasses per day, preferably dark French reds). The form of niacin we often choose is SloNiacin (Upsher Smith), available over-the-counter for about $12-14 per 100 tablets.

Mel started out with niacin 500 mg per day at dinner, increased to 1000 mg at dinner after four weeks. Although this is usually too soon to reassess HDL, Mel insisted. His HDL 41 mg/dl. Mel's disappointment was palpable. He was the usual type A personality: he wanted his HDL higher--now! So Mel insisted that we increase niacin to 1500 mg per day. (We never go higher than this if low HDL or small LDL is the indication for niacin; only when Lp(a) is present do we go higher.)

Six months into this process, HDL: 45 mg/dl. Still a sluggish response.

One year later, HDL: 68 mg/dl. Finally!

That is typical for niacin, as well as combination of lifestyle changes Mel made. None of them result in an immediate rise in HDL; all take months to 1-2 years to exert full HDL-raising effect.

Think of HDL as the 82-year old grandma who takes a long time to cross the street-she does get there!

Note: Doses of niacin >500 mg per day should be taken with medical supervision.

Can vitamin D be a SOLE risk factor?

18. January 2007 William Davis (6)
Here's a crazy question. It occurred to me as I was talking to Drew, a slender, active 54-year old dentist with no bad habits including no smoking.

Drew's heart scan score was 222. His lipoprotein analysis mostly revealed a lot of nothing, which is unusual. The only pattern that showed up was a modestly high LDL of 122 mg/dl with a very slight excess of small LDL. That's it. I would not be satisfied that these were sufficient cause for Drew's level of coronary plaque.

Drew's 25-OH-vitamin D3 level: 15 ng/ml--severe deficiency--despite the fact that his doctor had suggested that he take a vitamin D2 preparation. In other words, Drew had been profoundly deficient, probably for years.

Given the unimpressive cholesterol and lipoprotein values, could vitamin D serve as a trigger for coronary plaque all by itself?

I don't have an answer and know of nobody else who does. However, my opinion is that vitamin D is indeed a potent risk that can cause heart disease as a sole risk factor.

Perhaps it's another piece of circumstantial evidence suggesting that vitamin D has an enormous influence on health, including coronary plaque. Interestingly, the only other health problem Drew has had is prostate cancer, treated a few years ago with prostate removal and radiation. Good evidence suggests that vitamin D deficiency escalates risk of prostate cancer substantially.

By the way, I've seen people taking vitamin D2 preparations, called "ergocalciferol," who are every bit as deficient as those who take no vitamin D at all. Avoid D2 or ergocalciferol preparations: they're worthless.

Does fish oil raise LDL cholesterol?

17. January 2007 William Davis (1)
Katie had an LDL (conventionally calculated) of 87 mg/dl, HDL of 48 mg/dl.

She added fish oil, 6000 mg per day. Three months later her LDL was 118 mg/dl, HDL 54 mg/dl. In other words, LDL increased by 31 mg. What gives?

Several studies have, indeed, shown that fish oil raises LDL cholesterol, usually by 5-10 mg/dl. Occasionally, it may be as much as 20-30.

Unfortunately, many physicians often assume that it's the (minor) cholesterol content of fish oil capsules, or some vague, undesirable effect of fish oil. It's nothing of the kind.

Since we based Katie's program on (NMR) lipoprotein analysis, not conventional lipids (HDL, calculated LDL, triglycerides, total cholesterol), I knew that Katie also had a severe excess of intermediate-density lipoprotein, or IDL, and very-low density lipoproteins, VLDL. This signifies that after a meal, dietary fats persist for 12, 24,or more hours. Fish oil is a very effective method to clear IDL and VLDL, though sometimes it also causes a shift of some IDL and VLDL into the LDL class. Thus, the apparent increase in LDL.

Another contributor: Conventional LDL is a calculated value, not measured. The calculation for LDL is thrown off by any reduction in HDL or rise in triglycerides. In Katie's case, the rise in HDL from 48 to 54 means that calculated LDL is becoming more accurate and rising towards the true measured value. At the start, Katie's true measured LDL was 122 mg/dl, 35 mg higher than the calculated value. Calculated LDL is therefore approximating measured LDL more accurately as HDL rises.

The most important lesson to learn is that, if LDL rises significantly on fish oil and you haven't had lipoproteins formally measured, there may have been a substantial postprandial abnormality like IDL that was unrecognized.

Heart disease is everywhere

16. January 2007 William Davis (0)
If you ever need convincing that heart disease is everywhere, you should do what I do: subscribe to Google Alerts and have them forward news anytime the search phrase "heart attack" crosses the web. (Just go to Google, click on "more" to the right of the search bar, and follow the links.)


Some recent samples:


Workmates resuscitate driver after heart attack

A woman coal mine truck driver had a heart attack and required resuscitation with a defibrillator 3 times on the way to the hospital.





Heart attack kills groom at reception
A 34-year old man died during his wedding reception, leaving behind his 26-year old new wife.






Heart attack ruled as cause of crash

An Alabama man drove his pick-up truck into oncoming traffic while suffering a heart attack.






Heart-attack victim to return to Hamburg stage


Country music artist, Michael Harding, suffered a heart attack and cardiac arrest during a performance. He is apparently recovered and returning to the stage.



That's just a sample from the last two days. While you and I are carry on a conversation on reversal of heart disease, our neighbors and friends drop over every day. Even though I witness successful heart disease reversal routinely, the rest of the world is not participating.

Pass it on: Coronary disease is identifiable, preventable, controllable, and reversible.

Watch your weight plummet:Be a super vegetarian

14. January 2007 William Davis (0)
Here's a neat trick for losing weight: Become a strict vegetarian for 3 days.

Before you yawn or say "Yecchhhh!", let me elaborate.

Pick some time period. It doesn't have to be 3 days. It could be 2 days, or 5 days, or two weeks. But, for the period you choose, eat only vegetables. No meat, cereals, breads, milk, cookies, etc.

Vegetables alone could get monotonous, so make them interesting. Possibilities include:


--Hummus--add a little bit of olive-oil, chopped garlic, paprika, red pepper.

--Tabouleh--I get mine from Trader Joe's and it's delicious.

--Salsa--Low in calories, rich in lycopene and other flavonoids, with no nutritional downside. Also, pico de gallo--chopped tomatoes, onions, jalapeno chiles, cilantro, cucumbers.

--Mustards--hot, yellow, brown, spicy, gourmet, horseradish, etc.

--Cocktail sauce--i.e., ketchup and horseradish. Use the low-carb ketchup made without high fructose corn syrup.

--Tapenades--e.g., olive tapenade made with chopped olives, capers, and olive oil.
--Pesto-made with basil, garlic, and olive oil.

--Spices and herbs--basil, arugula, peppers, mustard powder, garlic, cilantro, ginger, etc.

--Vinegars--wine, Balsamic, rice, apple cider.

--Infused olive oils--infused with garlic is especially delicious,e.g., added to hummus.

--Bean dips--white bean dip, roasted bean dip, etc.





With the varieties of ways to jazz up your vegetables, you couldn't possibly be bored.

For example, for breakfast on day 1, eat sliced cucumbers and green peppers dipped in garlic-infused olive oil hummus and a handful of almonds. For a snack, some walnuts, sunflower seeds, sliced zucchini dipped in salsa. For lunch, a salad with an olive oil and balsamic vinegar dressing. For dinner, tablouleh, a cucumber and tomato salad, celery sticks dipped in pico de gallo.

All vegetables can be eaten without restricting portion size, since calorie content of vegetables are so low compared to other calorie-dense foods. (See The Heart Scan Blog from a few days back, "One bit or many mouthfuls?" at http://heartscanblog.blogspot.com/2007/01/one-bite-or-many-mouthfuls.html.)

This approach works nearly as well as fasting. A half-pound per day weight loss or more is common and painless. You'll also feel great living on low glycemic index foods.

(Photos courtesy Wikipedia.)

Dr. Agatston to the rescue

12. January 2007 William Davis (0)

Dr. Arthur Agatston, author of wildly successful South Beach Diet, has just released a new book titled The South Beach Heart Program. Dr. Agatston has started on a media speaking circuit to promote his book and concepts.


A reporter from Time, who interviewed Dr. Agatston, commented:

". . .not enough doctors prescribe niacin for their heart patients, even though the medicine is a proven treatment for raising 'good' cholesterol. Physicians are reluctant, Agatston suggests, because niacin requires diligent follow-up to watch for side effects, taking time that most primary-care practices cannot afford. On the other hand, he says, too many doctors are performing heart operations that represent a financial windfall for hospitals. Bottom line: there isn't as much money to be made in prevention as in treatment."

Amen.

Dr. Agatston echoes many of the concepts that the Track Your Plaque program advocates. His notoriety is going to help disseminate the idea that 1) CT heart scans are the #1 method to identify hidden atherosclerotic coronary plaque, 2) taking control of your heart scan score is the best way to seize hold of your future, and 3) the present-day popularity of heart procedures like stents and bypass is intolerable, inexcusable, and needs to be reined back.

Agatston also brings great credibility and fairness to the conversation and his comments will gain tremendous attention in the press and with the public.

When is a vitamin not a vitamin?

12. January 2007 William Davis (0)
When it's a hormone.

That's the stand that several researchers in vitamin D have taken and I think they're right. Dr. John Cannell has made a fuss over this in his www.vitamindcouncil.com website.

Structurally, vitamin D is most closely related to testosterone, estrogen, and cortisol. You wouldn't call testosterone vitamin T, would you?

Vitamins are also meant to be obtained from food. Yes, vitamin D is in milk but only because humans are required to put it there to prevent childhood rickets. Otherwise, the only substantial food source of vitamin D is in oily fish like salmon and then only a modest quantity.

Vitamin D is cholecalciferol, a hormone. Deficiencies of hormones can have catastrophic consequences. Imagine that every winter your thyroid gland shuts down and produced no thyroid hormone. You'd get very ill, gain 30 lbs, lose your hair, feel awful.

That's what happens when you're sun deprived and thereby deficient in cholecalciferol--you're deficient in a hormone. And it happens to most of us every year for many months.

I continue to witness spectacular effects by bringing 25-OH-vitamin D3 blood levels to 50 ng/ml with supplementation, including an apparent surge in success dropping heart scan scores.

An epidemic of heart disease reversal

10. January 2007 William Davis (3)
Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.

Second heart scan and heart attack risk

9. January 2007 William Davis (0)
At first, Joe felt disappointed, defeated, and frightened. After his heart scan, a radiologist at the center told him that his score of 264 was moderately high. He told Joe that he was at moderate risk for heart attack and that a nuclear stress test was going to be required.

This left Joe feeling confused. After all he'd had a heart scan 18 months earlier and his score was 278, 5% higher.

I reassured Joe that the radiologist had not been aware that Joe had a prior heart scan. The radiologist didn't know that Joe's heart scan score had actually been reduced.

In fact, Joe's risk for heart attack was not moderate--it is now very low, since his score was 5% lower. While growing plaque is active plaque, shrinking plaque is inactive plaque and thereby at far less risk for heart attack.

I wrote about this phemonenon in a previous Blog: When is a heart scan score of 400 better than 200? at http://heartscanblog.blogspot.com/2006_09_01_archive.html. When you've had more than one scan, the risk for heart attack suggested by the score takes a back seat to the rate of change of your score. In other words, even though Joe's score of 264 represented a moderate risk (of approximately 3% per year, roughly 30% over 10 years), this no longer held true, since it actually represented a 5% decrease over a previous score.

Joe's risk for heart attack is probably close to zero. ALWAYS view your second (or any subsequent) heart scan score in the context of your previous score, not in isolation.

Track Your Plaque newsletter subscribers: We will detail more of Joe's story in the coming January 2007 newsletter. If you'd like to read or subscribe to the newsletter, go to http://www.cureality.com/f_scanshow.asp.

Heart scan curiosities #5

8. January 2007 William Davis (1)
Despite the controversy over drug-coated stents, I maintain that the best stent is no stent at all.

Yes, there are indeed times when such things are necessary, but not with the frequency that they are implanted nowadays.

Another reason why stents are an undesirable phenemenon is that they muck up your heart scan. Take a look:





The long white object in the center is a stent in the left anterior descending artery of this 60 year old man. Just beyond the stent (at about 1 o'clock from the stent) is a plaque that could be scored. However, you can see that, with the presence of the stent, the bulk of this artery is no longer "scorable". If this man wishes to "track his plaque", he will have to be content with tracking only the circumflex and right coronary arteries, the other two arteries without stents.

The stainless steel or similar metallic materials of current stents simply prevent us from seeing through them for plaque scoring purposes. It's best if you can simply avoid getting one for this and other reasons.

Track Your Plaque Members: Watch for the upcoming editorial by our Heart Hawk on drug-eluting stents.