High Coronary Calcium Score: How do others feel emotionally?

Newbie here. I'm, for better or worse, an MD (ex ER, now hospitalist), been a health freak all my life, now age 72. Minimal to no risk factors until late 60s when my BP crept up to need-to-treat levels. Exercised all my life. I developed paroxysmal atrial fib 3+ years ago so I had a workup that included a CC score. I was blown away to find out it was over 2200. wtf?? Normal perfusion, treadmill, no exercise intolerance. I would have gotten an angiogram or coronary CT angio but I have a really bad reaction to IV contrast, so I won't do that unless I'm in a life threatening situation. I'd been on coumadin for 5 years for an unrelated malady (in addition to atrial fibrillation) and switched to a non-coumadin anticoagulant and took advantage of this to take large doses of Vit K (plays a role in moving vascular calcium to bone). I also started a statin. Game plan was to recheck my CC score in 3 years, which was this past summer. The new level was over 2600. ugghhh. Like many of you, I've felt like a walking time bomb. My cardiologist and other docs acknowledge that levels like ours are not well understood. btw, my atrial fibrillation was obliterated with 2 atrial ablations. At this point, I'm assuming that this calcium is mostly NOT in the intima (inside) of the vessel in plaque but is either medial (muscle layer of the arteries) or otherwise more external to the flow. That is, it is NOT highly correlated with plaque. I'd like to believe that anyway. In the meantime, I do what most of you do - I work out, take my statin (which seems to work very well), eat as reasonably as I can and, as my cardiologist suggested to me, carpe diem. An additional consideration for me is that I have chronic/late stage Lyme disease and have had cardiac involvement. My lyme guru doc suspects it's calcified Lyme biofilm. More oh well.......

@bluesdoc, I'm sure that I'm one of hundreds who are glad to welcome you to Mayo Connect and hope you can be with us for a long time. Can you help me understand how a statin is beneficial to a person with a high-calcium score in the arteries? Martin

Thanks Martin. Statins would not directly affect coronary calcium, but if or when it is a marker for high intimal atherosclerotic load, then lower LDL 'might' help slow plaque formation. I know that it's questionable how effective statins are for 'primary' prevention. In our case, IF our scores are markers for intimal plaque, then I'd view it as secondary prevention, for which statins have a track record. My cardiologist tells me that his group's income is down since statins have been in wide use. People with heart attacks used to come back for a second or third coronary event. No more. Apparently. It's an odds game, just like the rest of life. I tell my patients that when they fear the disease they have, or might have, to not forget that somewhere there's a bus with their name on the grill. You just never know....

Thanks @bluesdoc. That sounds to me as though statins would be most helpful to young people whose cholesterol is not yet blocking crucial arteries. I'm curious mainly because so many people with calcium problems report that their cardiologist just routinely added a statin. I'm also resisting it, because there is some good research showing that advanced-age seniors lose some memory thanks to statins. Again, glad you're on board. Martin

Well, everyone's different. Taking high dose CoQ10 with statins is important. For a study of n=1, in the three+ years I've been on it, it's had no impact on my cerebral function. I work in a highly challenging environment and have to make scores to hundreds of critical decisions a day. So far, so good. (Of course, it might be because of my music sideline, or working out a lot.... or genes? who knows.....) Thanks again for the kind greeting Martin.

There's something clearly amiss about our cohort - the way we're categorized by the cardiology community. I think they project risk in some sort of linear fashion from the levels clearly associated with those risks, ie, the low/mid hundreds. You'd think that if this were the case, we'd all be cardiac cripples with our high levels. But clearly, many of us are not. So, I suspect that very high CC scores could represent, in some cohort, a different pathophysiology than plain old calcifying intimal atheroma. This begs the question, what are we in store for, if not an early cardiac demise? I can't believe it's benign to have our vessels turn to stone, but how does that play out clinically? I don't know.

@bluesdoc I'm in a similar quandry. What does a high calcium score mean for an otherwise low-risk group? My calcium score is 1500, most concentrated in two coronary arteries. I'm 70,and have no risk factors other than age. I
have maintained lifelong fitness and did very well on the stress test with echocardiogram. That tells me that exercise has kept my arteries open despite the high plaque burden. The best I can do is to take a statin ( I started 40 mg of atorvastatin this week) and continue with a good diet and exercise, and stress management.

Well, @bluesdoc, I couldn't resist commenting on three of your points an hour ago. Everyone's different for sure, but apparently so are statins. FDA records show reported memory loss with a handful of different statins. If CoQ10 works for you, great! I've taken it for several years and still deal with drifting memory.

Borrowing your words, "there's something clearly amiss . . ." I will turn the corner and say that about Cardiology in several respects (which I won't articulate here without getting permission from a number of friends who feel their cardiologist is welded to long-running recipes for diagnosis and treatment by rote). The friends are referring mainly to Cardiology's fluid approaches to hypertension.

I have personal experience with vessels turning to stone, and it was very sad. My aged grandmother got past 70 years with no significant demise in her cognitive or memory facilities, but over a few years in her mid-70s she was overcome with severe dementia to the extent of becoming totally vegetabilized. Her diagnosis was arteriosclerosis. Both of her only sons also died in dementia. I'm hoping my mother's genes will save me from this empty end of my life. Meantime, I arise every morning asking what I might start today that I could pursue for another 20 years! Martin

Sure, Martin. Also, statins are different. I was initially started on the standby - atorvastatin - and my hepatic and muscle enzymes went nuts. At a later date, I tried pitavastatin, low dose, and did fine, and have for 3 years. So far....... Also, just to be clear, despite practicing clinical (mostly in the trenches) medicine for ~45 years, I offer no recommendations here. My only dog in this hunt is my own aging and beaten body. If we really knew what to do, we'd all be doing it...... jon

Hi everyone. I’ve been on here for a while and want to say I very much appreciate how open, sincere and caring all of the posters are. I am like most 59 year old male when with just high bp, cholesterol levels all over the place but healthy, CAC score was 693 my cardio put me on 80 mg stat amd baby aspirin. A year later I got another test ( Doc told me not too) my score was 1100. Doctors won’t do anything say it’s too risky to get into my arteries and get the plaque . So we just wait for something to happen seems to me that’s unacceptable. Is there anything we can take maybe from a health food store to slow progression of this plaque? I hear of vitamin k frequently. Good luck to everyone

@bigbern I'm also a part of our illustrious group with my 2316 score and was put on 20 mg of Lipitor and a baby aspirin. After reading research on the aspiring I opted to eliminate that. But I must say the Lipitor has done some remarkable things to my lipid profile blood tests. My wife has been on supplements for her ovarian cancer while at the same time doing the medical care things she should be doing. And she is now cancer free - in remission. So is her success from what the medical doctors are doing or what she's getting from the holistic doc? Impossible to say but as long as she's doing well no reason to stop. anyway - I started with him as well and here's what I'm taking: CoQ10 (Jarrow brand) he recommends 100 mg of it for every 10 mg of statin, K2 (Ultra K). magnesium buffered chelate, anthocyanins, something he calls Cardio 5 which he says works on multiple levels for vascular health, resting heart rate, etc..., and fish oil. I do not expect calcium scores to change one way or the other with these formulations but I do have some belief that they're helping in other ways.