I have a very high calcium score. What next?

I am a 67 year old with a CAC of 613. Pre-diabetic. BMI of 23. On Rosuvastatin 20 mg, Aspirin 81mg, and Amilodipine 5mgs daily
My LDL 36. Total Choletestrol 117, Triglyceride 64, HDL 67.
My cardiologist is recommending Ozempic 0.25 mg /week by injection for cardiac protection (not for weight loss or diabetes). My out of pocket expense will be $560 a month.
Anyone else got recommendation to start on Ozempic?
Any thoughts? Thank you

I haven’t heard of ozempic for cardio, but wegovy has been approved by the FDA for cardio and, therefore, even Medicare covers it, but you hit the donut hole very quickly and have large out of pocket until the next year. That was fine with me because it made me feel so bad I wouldn’t have continued taking wegovy after two months anyway.

Thank you. What I understand is both Ozempic and Wegovy are GPL-1 class of medications. I am pre-diabetic and that is why my cardiolgist recommended ozempic. Ozempic helps with insulin resistance as well. From the research I have done from limited evidence out there, GPL-1 group of drugs may give an additional 20% cardiovascular protection, which is significant in my opinion. Yes, I am hearing that the side effects can be difficult to tolerate. I haven't started that yet.
My insurance told me if my cardiologist preauthorizes it, I will have to bay a big co-payment for the first month and afterwards, it will be minimal for a year. I am still trying to decide.

I am on Medicare Advantage and my first month was something like $25, my second month was something like $125, then my third month and the months thereafter were closer to $1,000 because I hit the donut hole. Another problem with that is that it can effect my other meds to be higher because of what Medicare paid for those first two months. Anyway, I felt so bad. The reason you lose weight is because you are so nauseated and feel so bad you don’t eat. Not for me. For many reasons.

Good morning,
I would absolutely demand an angiogram and I'll give you my reason.
I am not overweight, work out 3-4x a week, total cholesterol of 102 (all cholesterol types are, and have been, well in line). EKGs, stress tests, etc always came out perfect. I've been a vegetarian for over 10 years. The model of good health, right? Wrong.
Took a calcium heart scan and my score was 2397!
Long story longer - after an angiogram it was discovered that I had 4 arteries over 90% blocked each. Cardiologist said a fatal heart attack was imminent.
Ended up having quadruple bypass surgery, which saved my life.
Please demand an angiogram.

So, lead, you had a nuclear stress test - with great ejection fraction? CT was fine, also?

Also, age and statin use would be helpful.

Yes. Nuclear stress test was fine, CT was fine. I'm 67 and been on statins for 7 or 8 years.

Interesting - your stats are much like mine!

Been through CT, stress with echo - all OK. Statins for five years. LDL 50, total cholesterol 100, CAC 2350. Just finished nuc stress test - either great LVEF at 78%, or high LVEF at 78%.

I started taking two 500 mg. doses of slow release niacin daily and my Lp(a) went down dramatically.

At least the expense will be limited to $2000 in 2025 thanks to the changes to Medicare. Still a lot, I know.