Any women with high CAC scores?

Posted by anniehall56 @anniehall56, Feb 1, 2021

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.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

Janell, Volunteer Mentor | @jlharsh | Jan 5 4:00pm

In reply to @nonna2four "Oh wow! Most of the calcium is in my LAD." + (show)

I think this is typical. That may be a good question to ask.

mayoconnectuser1 | @mayoconnectuser1 | Jan 5 4:01pm

In reply to @nonna2four "My A1C has crept over of the last couple of years. Diabetes runs in my family,..." + (show)

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.

kisu | @kisu | Jan 6 1:16pm

In reply to @nonna2four "I realize this is an older post, but I stumbled upon it when I was researching..." + (show)

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.

cnc51 | @cnc51 | Jun 26 7:22pm

Hi Annie Hall! I was so glad to read your post. I was told on Christmas Eve morning by my cardiologist that I have a CAC of 381. With Christmas hub bub in background and having no idea what that score meant I was shocked when he mentioned statins. I will write more about my story in a few days. Your story mirrored my confusion and even feeling of betrayal by my body as I am a vegan and walk every day. More tomorrow. Nice to meet you!

Janell, Volunteer Mentor | @jlharsh | Jun 26 8:46pm

In reply to @cnc51 "Hi Annie Hall! I was so glad to read your post. I was told on Christmas..." + (show)

Hi @cnc51, and welcome to Mayo Clinic Connect! I am tagging @anniehall56 and hopefully she will provide an update.

I share a similar story and score. My mom’s doctor recommended she get a calcium test as age 84. She asked me to go with her. I didn’t understand why they acted so strange trying to figure out what score belonged to who. They reviewed my 400 score…..then told my mom her score was 0. What?

I look forward to learning more about your story. What prompted you to get a CAC test? Is your cholesterol high?

swilkins1974 | @swilkins1974 | Jun 27 8:26am

In reply to @cnc51 "Hi Annie Hall! I was so glad to read your post. I was told on Christmas..." + (show)

My story is almost exactly like yours. My score came back at 396. Mainly in my LAD. I went in for a dye test and 2 stents in my LAD later, I am fine. I had a 70% blockage with absolutely no symptoms. That was one year ago. On statins now and feel fine.
I feel the calcium score test saved me from a heart attack and maybe saved my life. The only reason I went for the test is because of my father and his family history. My father passed at age of 48.
There is a light at the end of the tunnel.

kallettla | @kallettla | Jun 28 8:04am

My calcium score was 0. However, I have a 65% blocked carotid that we are watching AND aortic calcification. So, that doesn't give the full picture for me. I asked my Dr to test me for APOb, but he tested me for LP (a) instead, which did help. I have high LP (a). I read by the time we are 5 yo. our LP (a) is set. 1 out of 5 people have high LP (a), yet few Dr's test for it. There is no targeted drug, but there are some in the pipeline coming out very soon. Dr's look at me and tell me I am fine. I am 68 and thin, it makes me mad some just don't take this seriously. I follow Dr. Tom Dayspring, a lipidologist. He is on YouTube and both Dr Carvalho and Dr Attia interview him. He has given me great info! My goal is to keep my LDL below 30 with pharmaceuticals, it's the only way. I tried the Esselstyn diet and it didn’t lower it much. I too feel like a time bomb! I am going to use the FunctionHealth.com blood test. It covers many of the tests that are pertinent to cardiovascular health without having to convince a doctor. There is a $100 coupon off.

Best wishes to you.