Looking for Feedback

I’m not able to offer any feedback. I just had some labs, but I don’t think I got the LPA. I think I’ll ask though since my dad had cardiovascular disease. I don’t think I do. I hope you’ll get some input here.

My Dad also had cardiovascular disease and died young. However his lifestyle I believe contributed to his death, unfortunately.

@james617 , my dad had an ideal lifestyle active, thin, nonsmoker, no alcohol, etc. but he had quadruple bypass at age 63 with 4 stents in later years, but he recovered well, took meds and lived into his late 80s. And he did not die from heart disease! So, in a way he is an inspiration. I’m on a statin with cholesterol at 116. Things look good but I haven’t had CAC score. I’m like you in that I eat right and tight. I work out most days and manage good BP and BG. Still……I may be surprised at what I find.

Did your father have any procedures?

No procedures.

I think after your tests the MD will have a discussion about your risk of a cardiovascular event. I had similar numbers (the LDL was a bit higher) already on 80mg of a statin, but all the other tests were fine. He added Repatha due to my numbers and family history, so I now have to keep the LDL under 50, which was impossible with diet, exercise, and the existing meds. Adding Repatha (now in my 3rd year) my LDL is under 20, the ApoB is now in the low part of the normal range, so the risk profile looks a bit better. It's all I can do to keep the lifestyle choices ahead of what my genes would otherwise do.

Good luck in your journey.

I am a 71 year old male. Overweight and do not eat right. I had a triple in 2017 and just had two stents put in on August 11th. All my scores were in the low end of the normal range or actually just below it. Low blood pressure, low cholesterol scores. I have recently retired and decided that my priorities would be getting checked out for various health issues: Eyes, hearing, lungs, skin cancer and heart. I had to embellish heart related issues to get my cardiologist to schedule some tests. Did a sonogram and there were some irregularities. Had a CT scan and uncovered some serious issues. Had a cath prodcedure on July 24th and the surgeon said it was so complicated that she couldn't fix it and rescheduled with another surgeon on August 11th. One of my bypasses had collapsed and I had three blockages, two in the 80+% range and one at 90% (the widow maker!)

My point here is that I had to pressure my cardiologist to do the exams. All my markers were in the excellent range, and they could not detect anything listening to my heart with a stethoscope. Yet I was in critical condition and just barely dodged a bullet.

My advice to you and all on this thread is that if you feel something isn't right, you are your own best advocate and push for a cath procedure. That is the gold standard and the only way they really can discover what the state of your heart health is.

Good luck!

Hello. I'd say we have similar stories. I had CAC around 600 at 61 female. We're supposed to be protected a little longer than men I guess. I would have described myself similarly, regular exercise, running 20-30mpw or so over 5-6 days a week, watched my diet, not overweight. My lp(a) is mid 160s nmol/L.

The CAC was three years ago. Since you asked for thoughts, here are mine. Lots of people with high CAC don't have problems. Lots do. No one can tell us which we are. I had a CTA and it showed no blockages > 50%. Not sure why my cardiologist gave me one. I don't think it's standard. But it has kept me from going nuts over the high score. That cardiologist is my hero. He's not my regular cardiologist. It was a one-time consultation.

I moved to Ezetimibe + low dose statin to get my LDL and apoB down. They are both < 50. I've heard that apoB < 45 or so can reverse plaque (soft plaque I assume). Ezetimibe does not raise lp(A) or insulin resistance. Statins do (a small bit). Something to discuss with your cardiologist.

Many people (even fit, lean people) have blood glucose control issues and diabetes raises risk of atherosclerosis significantly. Worth a quick check.

PCSK9 inhibitors lower lp(a). They're not supposed to be prescribed unless someone cannot take statins. There's a trial (Horizon LP(a) I think) that's supposed to be reading out very soon. It tested whether lowering lp(a) led to fewer events in a population that have already had an event or have symptoms. There are trails coming that test it in primary prevention populations.

I go to a regular cardiologist. He's symptom driven. No symptoms=no problem. I think I am going to look for a preventive cardiologist. I'd suggest you read about/experience the difference and consider which is best for you.

But I'm just some schlub on the internet. :). Good luck to us both!