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Artery restenosis after stenting ... saturated fat vs. transfat.

I had a stent put into one of my arteries, and I was told the artery might close up again someday. How quickly does that usually happen? How will I know if it's starting to happen? If the artery doses, will the old stent be removed?

A coronary artery stent is a very small metallic tube that is inserted into a narrowed section of an artery and opens it up so oxygen-rich blood can flow freely to the heart. However, a stent is not always a permanent solution. Sometimes, scar tissue forms inside the stent and impairs blood flow; this is called "in-stent restenosis."

The rate of restenosis has decreased since drug-eluting stents (DES) were invented; a DES is a stent that slowly releases a drug that helps prevent the growth of scar tissue and the build-up of plaque inside the artery. Under the best conditions, less than five percent of patients with a DES require re-intervention at one year, while about 10 percent need another procedure within five years.

Once stents are placed, they are incorporated into blood vessel walls and cannot be removed. If restenosis occurs, treatment options include balloon angioplasty, which pushes the scar tissue against the artery walls, and placing a new stent inside the previous stent.

With restenosis, symptoms such as chest discomfort and shortness of breath may occur; these signs usually develop gradually, but you should report them to your cardiologist immediately so that he or she can evaluate your condition and determine if another procedure is needed. If the blockage in your artery has recurred several times or if there are multiple blockages, bypass surgery may be needed.

I think saturated fat is the most unhealthy type of fat, but my friend says trans fat is worse; which of us is correct?

Your friend is correct, based upon what research has shown. A multi-study review found that eating a diet rich in saturated fat, found primarily in full-fat dairy products, red meat, and processed meat, isn't associated with cardiovascular disease, coronary heart disease, stroke, type 2 diabetes, or overall mortality. Conversely, trans fat, which is present in some processed foods in the form of partially hydrogenated oil, was linked with increased risks for heart disease, death from coronary heart disease, and death from any cause.

However, these data don't mean you can or should increase your intake of saturated fat, since there is solid evidence that it raises LDL ("bad") cholesterol levels, which raises the risk for heart attack. In fact, other studies suggest that lowering saturated fat intake reduces the risk for cardiovascular events, such as heart attacks, by 17 percent.

The bottom line: Get most of your fat from plant foods in the form of mono-and polyunsaturated fats; vegetable oils, avocados, and nuts are good sources. Limit your intake of saturated fat, and avoid trans fat altogether if possible.

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Title Annotation:ASK DR. ETINGIN
Publication:Women's Health Advisor
Date:Oct 1, 2015
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