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Extremely high calcium score at 42 - is there any positive here??
Heart & Blood Health | Last Active: Apr 16 10:55pm | Replies (173)Comment receiving replies
After getting my 1029 CAC score at 59, I was in shock given my basic lipid profile has always been on target, my diet is pretty good, and I get 12K steps daily for 10+ years. With Crestor + Diet, we got my LDL down to 38, but after getting an advanced lipid profile (Quest Cardiac IQ), I discovered my Lp(a) was almost 300. I am pretty sure Lp(a) is the root cause of the CAC issues and it can't be controlled with diet or exercise. Hopefully, Pelacarsen, which is shown to significantly reduce Lp(a) gets approved before my time runs out... It's hard to treat CAC if you don't know the root cause of it.
Replies to "After getting my 1029 CAC score at 59, I was in shock given my basic lipid..."
So I’ve looked into the Lp(a) question. There was a major research paper on it released earlier this year that combined Lp(a) and CAC and assigned three risk tiers for cardiac events:
1) High Lp(a) *and* high CAC: Extremely high risk
2) Normal Lp(a) and high CAC: Not as high risk but still significant risk
3) High Lp(a) but no CAC: Lower risk
Personally, I fall into #2. Lp(a) level is totally fine. And yet my CAC is sky high. So for me the root cause is still unclear, and may never be. But even in that study, CAC ended up being a bigger driver of risk even than Lp(a).
My understanding of heart disease has really been transformed through learning about CAC. I spent so many years thinking it was all about cholesterol levels. But this is the number that really matters. And mine is about as bad as you could possibly get at my age.
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I don't know if the Quest Cardiac IQ also looks at cholesterol molecule size. It was the cholesterol size and type that explained my 0 CAC (aka Agoststen score) for Dr. Agosten on the then-available Berkeley Cardio Profile despite my chronic high cholesterol.
I've mentioned this before here...that molecule size and 'stickiness' are significant variables impacting plaque buildup. The percentage of those molecules is what over-rides my high cholesterol and puts me in profile/category A ("optimal").
Exercise and diet can trigger more production of the "big, fluffy, non-sticky" cholesterol molecules according to Agosten and my current cardiologist. I have stressed this here as it's one significant variable one can effect without even taking a statin.