low cholesterol

[sunni1]

I'm concerned about the medications my 68 y/o husband is getting. He had an MI (heart attack) Monday night (10-15-07) after coming out of surgery to stop a bad bleed in his bladder. (he had a catheter in due to obstruction which caused acute renal failure. So he was using the catheter while his kidneys recovered before the urologist did the TURP or whatever he is going to do. He went for a vigorous walk with his leg bag too low which caused the bleed - he did this twice! It became uncontrollable the second time) Anyway after they did the surgery and he had the MI, he was transfered to another hospital for an angiogram and they placed a stent in. He is getting out of ICU tomorrow. But I am concerned that they have him on Zocor which is to lower cholesterol with a goal of LDL under 70 they told me, but when I asked what his cholesterol was the lab report they gave me says Total cholesterol was 85 mg/dL, HDL chol 29 mg/dL, and LDL cholesterol was 36 mg/dL. When I asked about why they still have him on this statin drug to lower his cholesterol they said that after the MI his cholesterol was abnomally low because of proteins being released and that we have to wait a month for an accurate test. They still want him on the Zocor. This doesn't sound right to me if it is this low now. The doctor indicated that the lab test was invalid. Please advise.

[sunni1]

Thank you, Doctor for your reply.

[Darcy Green Conaway, MD]

I think this is a great question!  Most cardiologists would agree that the lower the LDL the better-- even at goal (LDL cholesterol of <70) one could argue during an acute coronary syndrome to use high dose statin-- this is often done for the pleiotropic effects (those other than reducing the LDL, such as "plaque stabilization". In fact, when we are born we have very low LDL cholesterols and indigenous peoples have exceedingly low LDL's-- around 50 and they don't die from coronary disease. Most of think the cardiac guidelines are still not tight enough...in a nutshell, I would also keep him on the statin (zocor) unless he has some contraindication.