Recently, a middle-aged uncle sent me a private message to me to ask me about this question, saying that in June 2019, he found a large plaque at the beginning of the right carotid artery. This plaque caused his carotid artery stenosis , which was about 70%, which was severe stenosis.
He should not have a carotid artery stent placed, and he has been taking aspirin and atorvastatin 20 mg. He took aspirin and atorvastatin for about half a year. He checked the carotid artery ultrasound again and found that his right carotid artery plaque has become smaller, and his plaque has changed from the previous low echo to the current isoecho plaque, which means that his plaque has begun to stabilize.
The question this uncle consulted me was that after he insisted on taking the medicine for the past six months, his right carotid artery plaque not only became smaller, but also became very stable in nature. More importantly, his vascular stenosis was also reduced compared to before. He has been discontinued from aspirin for almost two months and has no discomfort. He asked me if I could change the atorvastatin from the previous 20 mg to 10 mg to continue taking it?
First of all, I am very sure of this uncle's approach, because he insisted on taking aspirin and atorvastatin for half a year, not only reduced the carotid artery plaque, but more importantly, the degree of stenosis has also been reduced, which is a very significant result.
However, his carotid artery stenosis rate is 69%, and he is still in severe stenosis. He is also a high-risk group for cerebral infarction and , so he cannot stop taking aspirin. In addition, long-term use of aspirin and statins can achieve a certain degree of plaque reversal effect, so its atorvastatin cannot be reduced from 20 mg to 10 mg for the time being.
Research data shows that long-term statin can achieve a certain degree of plaque reversal effect, but moderate statins must be taken to significantly reduce LDL cholesterol and increase high-density lipoprotein cholesterol to reverse plaques and reduce plaques.
. To achieve the effect of plaque reversal, you can take statin to reduce the LDL cholesterol to below 1.8 mmol. Secondly, its effect of stabilizing plaques is more important than reversing plaques, because embolism or infarction will occur wherever the plaques go, which is extremely unfavorable to our human body.
Finally, for patients with carotid artery stenosis, it is best to take aspirin and moderate-intensity statins for a long time. Although statins have the effect of reversing plaques to a certain extent, they are required to be less than 1.8 mmol to occur only if they are less than 1.8 mmol. The plaque stabilization effect of statins is more important than the effect of reversing plaques!
OK. If you want to know more about prevention of cerebral infarction, reverse carotid plaque, etc., you are welcome to subscribe to Dr. Zeng’s paid collection series:
"It’s easy to prevent cerebral infarction" 100 episodes
"How to prevent carotid stenosis" 30 episodes
3
