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High CAC Score and Current Status
Hi All,
I am now 68, have slightly elevated BP that has been controlled with Telemisartan/irbesartan (20mg/d) for 20+ years. I am 10-15 pounds overweight and am very active, but do not “work out” - lots of walking and maintenance on rental houses. I have had both hips replaced. Father died from lung cancer at 50 yo (3 pack a day and risky work - boat paint, propellor grinding), mother died from infection at 87 yo. Sibling early diagnosis of pancreatic cancer at 64 yo - good chance of long life due to early diagnosis and quick action.
In Sep 2019, given the low cost (no health related reason), I had a CAC (coronary calcium) test - a few days later I left on a two week vacation to Europe. Got back home to find a letter from my doctor, indicating the CAC test was “abnormal” - like 1340! At this time: Triglycerides 120-140, total Cholesterol 120-150, HDL 40-46, LDL 60-110. Never any medical issues other than hips and somewhat elevated BP.
I immediately reviewed options, met with cardiologist and started atorvastatin and Vascepa (have also taken 81 mg aspirin for the last 20 years). Did walking treadmill stress test within a couple of weeks. "Bruce protocol, normal sinus rhythm at rest, 9 minutes, no shortness of breath (legs got tired on the elevated portion), METS 10.3, peak heart rate 159, peak blood pressure 195/90, no ST-not T changes diagnostic for ischemia, occasional PVC. Conclusions: 1. Negative treadmill stress for inducible ischemia to achieve workload, 2. Achieved 10.3 METS. Placing patient good for functional capacity for age, 3. Duke treadmill score of 9. Placing patient at a low 5-year cardiovascular mortality risk."
No one recommended a re-test for CAC. Cardiologist indicated they are rarely inaccurate.
Next series of blood work - note massive decrease in triglycerides
Jun 2020 - Triglycerides 56, total Cholesterol 115, HDL 48, LDL 47
Feb 2021 - Triglycerides 60, total Cholesterol 121, HDL 46, LDL 53
Aug 2021 - Triglycerides 27, total Cholesterol 99, HDL 46, LDL 39
Mar 2022 - Triglycerides 49, total Cholesterol 106, HDL 46, LDL 47
Fast forward to today - very active, just returned from a month long tour of Portugal and Germany where we averaged 8-10 miles a day walking, rolling luggage in and out of airports, trains, and cars. Walk and work on something daily - do not watch sports - ie not a couch potato. I still feel great - and have felt great for decades.
Thoughts? Another CAC test? Another stress test?
Thanks to All!
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Quick update ... met another cardiologist unintentionally when my wife had a TakoTsubo Syndrome (TTS) episode (doing well and expected full recovery).
While chatting at her follow-up, I briefly outlined my scenario to him (he is fellowship trained, young, aggressive and strongly supportive of technology). He said he agreed with my cardiologist, and given my great blood numbers, good stress test, and complete lack of symptoms he would not even recommend another stress test. His opinion on CTA was the same as the other fellow. He did note he thought a Boston Heart Panel would potentially be useful; however, this blood work looks a bit like the CardioIQ panel.
I am not a big supporter of duplicate CAC tests---getting more CAC if you are on a statin is probably what will happen...seems literature says that may be a good thing to stabilize any plaque. Just my opinion....
What was his opinion on CTA?
My cardiologist was upset that I would waste the scan - clearly a post de facto issue, since it COULD have been very diagnostically useful.
He was also bothered that I talked my PCP into supporting the additional tests ... CTA, PAD, stress with echo, and Cardio IQ.
I may fire him and find someone less concerned about me doing more on my own behalf, versus being impressed by how right he is.
Does Vitamin K2 can reduce calcium in the arteries, and if so would the plaque become less stable?
SteveSH,
I answered on another post to you ... to my knowledge, once calcium is present, it cannot be changed - it will only increase over time, so it is important to address slowing the increase.
As I understand it, plaque will be calcified by statins so your CAC score will go up initially on statins, but your plaque levels will be more safe.
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1 ReactionTo add to this, I've read several reliable articles that state that each calcium CT scan is equivalent to a year's worth of sun radiation, so if you're going to redo the scan, I'd wait a minimum of 3 years (if not 5) to limit your exposure to radiation.
hiker,
I just reviewed a few articles - one summarized the complex topic by noting a CT for calcium was about the same or tiny bit more radiation than a mammogram.
So--I work in this field (Radiology) and the dose is about 10 1 view chest x-rays. Radiology professionals use the term ALARA (As low as reasonably achievable)...why...because nobody knows what level of radiation exposure may cause a spark to go off in the human body to cause issues...e.g. cancer. So, doing a radiological exam is all about value vs. risk.
Thanks for that info jasper. For those (like myself) who found out they had high CAC scores thanks to the calcium CT scan, it was definitely worth the risk.