Lipitor and Tissue Valves

[Mike From Michigan]

Are any of you with tissue valves on Lipitor (or similar drugs)? My cardiologist recently put me on a low dose (10 mg) of Lipitor because of the anti-calcification effects it has on the blood (not specifically to lower my cholesterol which is usually OK). He said it is a relatively new therapy that will hopefully further prolong the life of a tissue valve. As we know, calcification of the valve leaflets if the primary enemy of tissue valves, both original and replacement. The new anti-calcification treatment processes used in the preparation of replacement porcone & bovine tissue valves, along with taking meds such as Lipitor will hopefully increase the expected average valve life to over 20 years (even in younger patients), at least in theory. My cardiologist and surgeon are both very optimistic about all this. Of course time will tell the real story...

In fact, it was the relatively new anti-calcification treatment of the Medtronic Mosaic (3rd generation porcine valve) that sold me on that valve...

 

[Kyla]

This is a new suggestion to me. I wonder if a child of 10 could take such a medicine. We were told that her valve would last any where between 5-10 years. 20 upward would be fantastic. I'm going to ask about this treatment.Thanks!

 

[Dirk]

There are some studies that Statins, Lipitor is a Statin, slow down calcification in case of aortic stenosis.

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15210526

It could be- hopefully - the same effects with implanted tissue valves.

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=14675593


The REVERSAL study proved that 80 mg per day stop progression of arterial calcification.

http://www.clevelandclinic.org/heartcenter/pub/news/archive/2003/reversal11_13.asp


However, statins decrease coenzyme Q10 blood levels which could damage the heart. Q10 supplementation could be necessary.

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15210526


Dirk

 

[Phyllis]

Dick was prescribed 10 mg. of Lipitor by Dr. Cohn to keep the valve from calcifying after surgery in December 2003. He never had high cholesterol. When he had a blood workup and we received his cholesterol numbers in February, they were alarmingly below normal. In agreement with his local cardiologist, we stopped the Lipitor. Dr. Cohn may be right, but Dick, who before heart surgery hesitated to take even an Advil, decided to stop the Lipitor.

 

[Dirk]

From my understanding there are no cholesterol values too low.

What mean alarmingly too low?

What is a normal value?

These dates are not really defined.

I.e. someone with cardiovalscular disease schould have LDL very well below 100 mg/dl, which is much lower than normal.

Now: A tissue valve does not have anything to do with cardiovascular disease, but one could think to get the same cholesterol thresholds for that than for treating calcification in the arteries.
This could make sense.

Or?

I do not know either, just some arguments for discussion.

Greetings


Dirk

 

[Phyllis]

Dick's total CHL dropped to 123, normal is below 200
HDL was 50, normal above 35
VLDL 20, normal is below 30
LDL 53, normal is below 160 - that was the one that alarmed us and we asked the cardiologist if there is ever such a thing as "too low".
He suggested cutting the statin dose in half and later agreed to cutting it out completely.

Test just taken a month ago after being off the statin since last February:

CHL 190
HDL 49
VLDL 24
LDL 117

Dick's arteries were clean - he'll take his chances unless his numbers go up.

 

[Phyllis]

Mike - an interesting thread related to this topic is:
http://www.valvereplacement.com/forums/showthread.php?t=8198

 

[Mike From Michigan]

Cholesterol levels

Cholesterol levels

Lowering one's cholesterol below acceptable levels via meds like Lipitor is a concern. My cardiologist already said we will check my cholesterol levels next month and keep monitoring it as required along with adjusting the dose as necessary.

 

[Raverlaw]

Even though I did not previously have high cholesterol, the degree of calcification on my old bi-cuspid valve was severe. As a result, Dr. Faber, my surgeon, put me on a low dose (10mg) of Lipitor and told me that "everyone" should be on Lipitor to prevent atherosclerosis. My cardiologist agreed, so long as I do not have liver problems. So I'm still on Lipitor and my cholesterol numbers are trending down, except for my HDL, which is up slightly, probably because of positive changes in my diet. I get a blood screen every six months and the cardio will re-evaluate with each of those tests.

I had a little bit of muscle cramping associated with the Lipitor when I first started on it, and again when a prescription ran out and I was off of it for about ten days before starting up again. The cramping seems to taper off with continued use. I've not experienced any other of the many possible side effects.

Kristin, I would hesitate to give this drug to a child unless the doctor is positive there will be benefits - I think that very long term use could cause liver damage, among other things. The benefits may outweigh the disadvantages, but I don't think that the risks (in a child) are worth taking it because it 'might' help prolong the life of the valve. At her age, she is going to have a second surgery no matter what.

 

[Bryan B]

My cardiologist put me on Pravachol for the same reason...to slow down the calcification process. He said he may switch me to Lipitor but wanted to wait until it's been out for awhile. It turns out I have borderline high cholesterol anyway so now I have a "reason" to be on it. When I told my surgeon I was on it and why the cardo initially put me on it he just rolled his eyes. I guess he feels that with a Ross the autograft is not as susceptible to calcification and the calcification process on the homograft pulmonary valve would be minimal in effect. In other words...my cardio did not take which procedure I had into account and just lumped me into the "tissue valve pile". Yet my RPh says he thinks everyone over 40 who tolerates statins should be on them preventatively.

 

[tobagotwo]

The following is my opinion only, as I cannot provide documentation for it:

The brain requires cholesterols in its neurological processes. Too low a cholesterol level can interfere with normal cognitive abilities. It is my understanding that aggressive use of statins has been traced to muscular and cognitive issues in some otherwise healthy patients. Although there are suits being settled out of court with no-tell clauses, word of these issues is beginning to leak out. In the next few years, I will look for lawsuits to this effect.

This doesn't mean statins can't be useful, or even necessary, but please be cautious, especially if you do not have a cholesterol problem. This isn't like taking an aspirin to avoid clots.

Here is a link to a forum thread about this: http://www.valvereplacement.com/forums/showthread.php?t=7446

Best wishes,

 

[Dirk]

Phyllis and Dick:

I see, your LDL became quite low.

Bob: Today some believe that the postive effect of Lipitor on calcification of natural or implanted tissue valves is not due the lowering cholesterole but due to other effects on he tissues.


Dirk

 

[tobagotwo]

I totally agree, Dirk. And the apparent anticalcification assistance of statins can certainly be helpful additions for those who have cholesterol issues as well.

My concern regarding this use is that the "side effect" is a lowering of cholesterol, which may not be a universally beneficial outcome, particularly for those who do not have a recognizable cholesterol issue. The liver does not seem to be the only place where this can have negative effects for an undetermined quantity of users.

Best wishes,