High Lipoprotein(a) but CAC Score 0

@leeosteo I have been playing with low/carb and keto, although not since about 2021 when my heart began to act up and I eventually needed two catheter ablations. And my girth has grown commensurately. A work in progress...

The science is still growing and arguing. I follow Dr. Rob Cywes on his YouTube channel, but have listened to countless lectures by Dr. Stephen Phinney and Dr. Nadir Ali, all high-priced, highly educated, some with two PhDs, and running businesses and giving lectures to cardiologists. They favour meats, dairy, lots of animal fats, even putting a pat of butter on a steak if it helps to ward off hunger pangs. Their science is impeccable. Then, others point to strong evidence that a Mediterranean diet is the way to go, and it is very strong indeed. I now follow the channels of only two people, both on Youtube: Nutrion Made Simple, Dr. Gil Carvalho, and Dr. Nick Norwitz. They seem to have a strong thumb on the pulse of things edible, and between them I get good information. I have not looked specifically for articles stating that animal fats are good or bad....but I believe that some if it is good. Plant oils must be of impeccable quality...and they must be fresh and used up within a few weeks of opening, refrigerated, or discarded after about three months. I learned this starkly two years ago when my wife had a mastectomy and our middle daughter came to be with us and get us through the rough patch. She baked some 'energy cookie balls' and they had some flaxseed I had in the fridge since Christ was a corporal. We both took one look at each other, hers quite accusatory, when we each bit into one of them. She grabbed the bag and looked at the long-since-murderous best-before date, and then waved it in front of me. I had to hang my head and agree I'd messed up. The entire batch had to be thrown into the bin.

Seed and plant oils are not necessarily bad, but they CAN be. Do your research about the best quality brands, and don't hang onto it more than about three months...even if it's in the fridge.

@dianempx // my Lp(a) was never that high, but I nearly halved mine from 92 nmol/L to 49 nmol/L by adopting a very low carb / keto diet. 10 mg rosuvastatin, 10 mg ezetimibe daily for 15+ years.

So high levels of Lp(a) might be hereditary but perhaps they can vary somewhat according to lifestyle?

There is no insurance approved treatment for lp(a), but there are drugs that have been proven to dramatically lower lp(a). The next step, that is ongoing, are studies that show lowering lp(a) lowers MACE. There's a study that is expected to conclude this year. Then FDA approval. Then insurance coverage. The studies I looked at for impact on MACE required 175 nmol/L or greater. So there's also the issue of who would qualify if/when it makes it to insurance coverage. Best case, a few years out? At least this is my uneducated understanding of the process.

@gloaming keto diet is very bad news especially with any cardiovascular issues. It's way too much fat . My doctor says people will eventually be sorry they did that .

@19281928 That's not what we're seeing, and not what many doctors say, including highly regarded cardiologists. See the channel, 'Low Carb Down Under' on YouTube, and Drs Rob Cywes, Nadir Ali, Stephen Phinney, Eric Westman....I could go on....

@gloaming I believe it because when I eat saturated fat my cholesterol jumps . I don't eat meat anymore. And very little saturated fat which is keeping my cholesterol good 44 for LDL
103 for LP(a) when I ate high fat it was very bad (LDL) so I believe my cardiologist and my doctors . And the proof of my lab results. It's ok to disagree. We can have different beliefs 😉

I recently went thru some testing, mainly because I requested some extra testing due to both my grandmother's stroke history.

I have a very high HDL and relatively high LDL, but a good ratio with low triglycerides. Most doctors don't even think about doing further testing because of the unusually high HDL and good HDL to LDL ratio and low triglycerides. Further tests though showed that I do have a slightly elevated ApoB (Apolipoprotein B) and a mild elevation of Lp(a) (Lipoprotein a) although my homocysteine levels are in the normal range. So the picture became more muddled.

So I have a mixed picture of cardio health....so CAC enters the picture.....

My doctor scheduled a CAC test. This showed a below 11 count in one artery and "mild" plaque on one valve. Copilot told me that both these places are where plaque is prone to accumulate, based on how the blood flows and moves. An ultrasound is scheduled to check to make sure that that small amount is not impeding the valve.

Then to gain a clearer picture.....

I took all the numbers and fed them to copilot to look up all the research and standards and tell me what all these tests together mean to me, and if I need any further tests to further clarify.
Copilot told me that the tests with the LDL and the APoB combined with the CAC showed that the LDL particles are likely larger and less numerous and the plaque CAC biology information showed that plaque accumulation is slow and non-aggressive due to my age, 73 and the low level of plaque even in the areas most prone to plaque accumulation with age.
Copilot: A Carotid Ultra Sound was recommended in the future for me because of the potential stroke risk in my family.

What I am saying is that the tests layer over one another to form a picture of cardio health.

It is like those progression pictures that we saw years ago where there was several pages that were meant to layer on top of one another; when they were all in place the picture emerged. All the tests layer onto one another and a full picture emerges when you put all the tests together.

I have found that copilot has been invaluable in helping me understand what is happening and how it affects and reflects my health. My doctor appreciates me using copilot because I am able to listen and understand her quickly because I have done the research before I see her, and I am not calling or going on line to ask her questions constantly about procedures, reasons and what this means. I can spend my time with my doctor more productively, and I am less stressed. Plus, plus!

@leeosteo my doctor prescribed repatha injections which lowered mine from 129 to 103.
There are medications in study trials currently. I have moved to another state and my new cardiologist has not Heard of the new drugs which is scary . Be sure and be your own advocate . He also displayed LP(@) and said everyone could have plaque break off and just live your life and don't worry about it. My last cardiologist was very different and concerned. health care is not so good anymore