Any women with high CAC scores?
I'm new here. Passionate 64-year old Italian-American college journalism professor married to a gastroenterologist who thought I was in great health. Eat pasta, lots of vegetables, fruit, and little meat, never overweight, look young, feel young, but my dad and four of his brothers dropped dead of heart attacks in their 50s. I've always had elevated cholesterol and triglycerides with elevated glucose levels since my 30s, but high HDL. Not one doctor, including my husband, has thought much of it because "I'm a woman" and appear to be the epitome of health. Everything changed 10 weeks ago when I decided I should have some overdue bloodwork. Cholesterol was 280, LDL 170, triglycerides 272, A1C 6.5 and HS-CRP 10. Scared me to death and decided to have the Calcium cat scan, thinking it would be a zero. It came back at 256, with 255 in the LAD. I've had zero symptoms, dance aerobics 45 minutes a day, no shortness of breath. Had the nuclear stress test the week after which came out perfect. WHAT THE HECK? According to the MESA score, I am at the 92 percentile which puts me at high risk for heart attack and stroke, and according the MESA, my arterial age is 79?? Husband got me in to see one of the top researchers of CAC and CAC progression next week at UCLA where he practices but I'm in total disbelief. I don't take statins but may have to (which raises CAC score), taking an aspirin a day, went full strict no refined carbs - goodbye pasta and bread- and lost 15 pounds in 10 weeks which puts me at a weight I was in my 30s. Understand that you can't reverse CAC score but you can stop the progression. That's all I care about right now. Determined and interested in anything you have to say and anything that's worked for you - supplements, diet, vitamins. Have read all your posts (it's my new past time- misery loves company, right?) and have heard of Vitamin C, K, magnesium, fish oil, Co-Q10, niacin, aged garlic). Will post after my appointment next week and share what this doc says (he's written half the studies that come up on CAC, CAD, and CAC progression). As many of you post: I feel like a walking time bomb. Questioning if learning of the CAC score is a blessing or a curse. I went from a very happy person to a total wreck who is relieved to be teaching online for another semester because I don't want to have a heart attack or stroke in front of my students. Sigh.
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I think this is typical. That may be a good question to ask.
Not a medical professional!
A stress test with echo will be helpful for you to understand your circumstances - here's a good explanation of the differences - https://vacardio.com/echocardiogram-vs-stress-echo-discerning-the-differences/#:~:text=A%20stress%20echo%20is%20a,or%20“stress”%20of%20exercise.
Regarding your concerns - please be calm as the calcium scan doesn't provide a one stop information picture. Ex: I'm 70, five years ago had a CAC test on a whim which came back at 1350 (I had just started on statins about a year prior due to age and history of elevated BP which had been controlled for 30 years). Stress test was excellent. Waited two years - second CAC was 2300 - another stress test with echo - excellent results, again. Waited another year and had a nuclear stress test. Again, an excellent outcome with over 75% ejection fraction.
So, high CAC could mean you have major blockage, or it could mean the calcium is not actually all in the artery, or it could mean it is in the artery and your arteries have positively remodeled themselves to allow suitable pumping ... I would like to completely understand my circumstances, but with good stress with echo, and good nuclear stress test and no symptoms ever, we are in the wait and see mode - I don't like this, and at some point may push for a catheterization to allow docs to actually "see" the arteries.
My lipid numbers are similar to yours due to Lp(a) 106 and APOE 3/4 (the 4 prevents me from clearing LDLs efficiently). My CAC, LAD is 74. Get your LP(a) lipid tested along with your APOB. APOE is a genetic blood test. Taking a statin can raise Lp(a) by 20%. I've been approved for Leqvio, which reduces LDL by up to 50% and LP(a) by up to 26%. No amount of exercise, diet, or statin can reduce Lp(a) because it's an independent factor. There are no drugs as of now to target AP(a). But drugs are coming up that are in their final stages of trials. For now, there are two other PCSK9 that reduce Lp(a) similar to Leqvio.