High Coronary Calcium Score: How do others feel emotionally?

I was told by my Cardiologist that the risk of doing invasive cardiogram outweighs the benefits. In other words there is nothing I would do differently based on the cardiogram. Do you agree Bluesdoc? Like you I have a high CAC score of about 1500

Hi again, Tim. Yes, I agree. CAC scores are statistically associated with coronary risk, but there are plenty of outliers, ie, someone with a CAC score of 400 and no plaque on angiogram (a case my cardiologist had). And those of us with scores off the charts, no one understands the meaning. If Annie, with a CAC score of 256 is in the 92nd percentile for MI risk, those of us in the thousands ought to be dead several times over. Apparently, we're not.

@bluesdoc Your response made me feel a little better. Thank you.

Thanks, bluesdoc. I'm glad I had the CAC scoring done two years ago. I am already a lifelong exerciser, but I did change my diet to follow American Heart Association guidelines (Mediterranean diet) I've come to terms with the high score, and no longer feel that it's a Damocles sword hanging over my head. So unless I become symptomatic, I'll continue to follow the best heart-healthy practices, including taking a statin to keep LDL in the 50-70 range.

Just had my one year check up after a quadruple cardiac bypass surgery. I am fully recovered (except for the mammary vein that was used in the process, which still stretches when I work out). I had a CAC score of 886. You can't go by that whole number, but there is a breakdown that tells you where the blockage might be. I was completely asymptomatic, but after the cardiac catheterization was told I was not a candidate for stents and was recommended to a surgeon. When I think back on everything I went through with the surgery, the ICU, the long recovery, I wonder if I could have skipped that whole thing. Bottom line if you have a family history of stroke/heart disease you are a candidate for some procedure. It becomes a choice of a planned event or an unplanned emergency. I am told because I was asymptomatic, my heart muscle is still healthy. Of all of my friends in my close circle I was considered the most active, health conscious one. Worked out 7 days a week, ate organic, had the occasional drink, never smoked. So it is an irony when you read a quiz that tells you how to change your lifestyle and you can check all the boxes! So what else is there to change.

We have a choice of living under a Damocles sword or getting on with our life and doing all the things we can, while we can. For those of you with an engineering background -- our bodies also have an MEP system -- Mechanical, Electrical and Plumbing. So I learned today that while my plumbing and mechanical systems were fine, I had an issue with my electrical system which seems fine but would require a pacemaker in the future. I should never have let anybody tamper with my system. I have great doctors and think they all did a great job. But I feel like a used car, with frequent tune ups and always something new that is being discovered that needs more attention.

I am very grateful for this forum. I don't feel like I am alone. And it allows me to lead the good life. Whether or not it matters, I continue with my good lifestyle, working out, eating healthy and making a positive impact on others. But I am done. Not sure where my thinking will be in a few years if I actually will need a pacemaker. But for now, I have been very blessed, I have had a good life and when God is good and ready, I will go happily and without fear or regret. No more surgery for me!

Thanks so much for sharing your experience, chi. Its sounds like everything has worked out well for you. I have a friend who had a cardiac bypass surgery. Do you know why they did a cardiac cath procedure if you were asympotmatic?

Because of the CAC scoring and the stress test. I did not sweat, was not out of breath or tired when I did the test. But the printout showed some irregularity. And then there was the family history. The cardiac catheterization showed them where I was blocked, and determined that I was not a candidate for a stent.

About 3 years ago, I was diagnosed with high CAC ~ 2000. I am asymptomatic. I take a statin and a BP med to maintain very low values. I have always exercised vigorously. I am 71 years old, not overweight. The only behavioral modification I have made since my diagnosis is dietary and, that has been minor. I have been able to convince myself to not worry...my hip bothers me more than anything so I stopped running but I still ski, hike, play tennis.

The literature regarding high CAC seems overwhelming but it is a probability factor rather than a sentence. As someone said, there are outliers so there's always hope!

You're right about the CAC Score literature being overwhelming, but I like your statement that it is a "probability factor rather than a sentence." The fact that I have changed my diet has made me feel better about avoiding a heart attack or a stroke. Anxiety over heart health is a risk factor for heart attack. Go figure!

My score is 1852. In addition to the CS you should have a NMR to get the technicolor on your lipidology. Your small particle LDL is key. My LDL on standard testing has been under 90 mostly under 80. HDL over 60. Triglycerides under 100. I was going along assuming (by the normal cholesterol testing) my CVD risk was less than 1/2 the general population. I had been on statins for twenty plus years and normal height and weight with no cormobid condition's. My curiosity was raised after a corodid ultrasound showed a 40 percent blockage. I then ordered the above tests as well as a apo(a) that all confirmed my pathogentic small particle cholesterol numbers. The calcium score for the most part shows stable plaque with much lower risk for stroke and cardiac event. The little disclosed fact with statins is they convert cholesterol to calcium abeit mostly a stable form. I asked my cardiologist why they aren't testing for the pathogentic small particle cholesterol is since there is no treatment why test. The treatment for blockage is stenting which is one of the most profitable cardiac procedures this with statins being a blockbuster profitable drug it's no wonder what I discovered is not publized by anyone.
I firmly believe in full disclosure informed consent.

In saying all of this, is there a drug that lowers only pathogentic LDL? Not based on my research. Niacin, Vit-K, fish oil ..etc may help.

To reduce my risks I keep my blood pressure on the low side less than 110/70. Take ASA get at or above your requirement for sleep.

Lipidology is a field still in it's infancy.

Just my take on the subject.