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Jun 13Liked by William H Bestermann Jr MD

Bill is a friend and savant. As a board-certified cardiologist, I find his call him a great help and even educational. However, this, and contains several mistakes and gets a "wrong" description from me. IF the medical therapy is aggressive enough after angioplasty, that angioplasty not only relieve symptoms but prolongs life. What is called soft plaque here is only the cause of half of myocardial infarctions. Bill and I do agree that the key is to obtain those risk marker values were risk regresses to ZERO: non-HDL cholesterol of 90 or less, triglycerides of 100 or less, A1c not above 6.2 at age 62, BUN 12-14, hemoglobin 12-14, uric acid 5.5, cardiac C-reactive protein 1.0, BP 110-115/60-70 if on no medications and 125/80 or less if on medication for blood pressure, 11-23% body fat or less. All of this can be done naturally without medications, but if medications are necessary than they should be used while this path is en route

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We will just have to agree to disagree and this is a place where the scientific evidence is especially critical. A stent in a stable patient does not reduce the risk of sudden death or heart attack. Full stop! It does reduce symptoms but optimal medical therapy without a stent relieves symptoms completely in 70% of patients within a year. It is the medical therapy after angioplasty that prolongs life. The angioplasty is merely an alert that gets the medical therapy started. The ORBITA trial is especially interesting to me. An angioplasty did not increase the ability to exercise on a treadmill any more than a sham procedure in a controlled trial. That even surprised me. OMT first is the proper path in stable patients. A stent is only appropriate for pain relief if OMT fails to relieve the pain. Of course, a stent will save your life if there is a acute event and the patient is unstable.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32714-9/abstract

https://www.nejm.org/doi/full/10.1056/NEJMoa070829

https://www.nejm.org/doi/full/10.1056/NEJMoa1915922

https://www.ajmc.com/view/aug08-3509p521-528

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Jun 13Liked by William H Bestermann Jr MD

Thank you so much! Will share to get this important information out there!!!!

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I especially appreciate the way you spread the word

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