I have a very high calcium score. What next?

I tried to find the Arizona Risk Calculator.. do you have a link? I’ve been living this for 18 months and like most of you there is always this dark cloud hovering. I’ve made the changes, now I’d like to be optimistic of the outcome.. at 63 with a cac of 2418.. it sometimes seems overwhelming. If someone has the link that would be great.

I typed in "Arizona Heart Risk Calculator" and the first citation is: https://heart.arizona.edu/heart-health/heart-attacks/heart-disease-risk-assessment

That study was released in 2019 I believe so it's fairly recent and most likely still the standard. The most important thing it states is "referral for stress testing and cardiology consultation should be delayed until evidence of unstable angina exists. No immediate or long-term benefit to such individuals from either stress testing or coronary angiography has been documented in the literature." I see a lot of folks here running to do these things after getting a CAC score and it's really not needed, according to that study anyways. Since you are over 400 however they do suggest getting your LDL below 70 along with the dietary and lifestyle changes for everyone else under 400.

I don't agree with the reading. If your CAC is 400+ It is not necessary to have the stress and EKG tests but the risk of a stroke or heart attack exists. It will exist forever although you can stabilize your condintin by improving life style (diet, exercise + statins). I am asymptomatic but my score is close to 1600. Numbers don't lie. My liver produces too much cholesterol.
As far as the angiogram the imaging of the blockage in your arteries are facts as well. I didn't run to the angiogram believe me but with a score like the one I have I needed to know the exact blockage percentage on my LAD.

I'm a little confused as what you said is what the study supports. They are talking about asymptomatic individuals; such cases, with suggested immediate statin use, dietary and lifestyle changes and the suggested changes in LDL-C, hs-CRP inflammation etc are needed in asymptomatic individuals.

The study:” No immediate or long-term benefit to such individuals from either stress testing or coronary angiography has been documented in the literature." I see a lot of folks here running to do these things after getting a CAC score and it's really not needed,…”
I don’t agree with that.

Well everyone is entitled to take whatever actions they want when receiving news of a CAC score, getting cardiac catheterization, stress testing, coronary angiography etc if you're asymptomatic and making recommended dietary and lifestyle seems like overkill to me, as referenced by the study.

Thanks for letting us know.

doing an angiogram to me is not over kill. I did a doppler test but the doctor wanted to have more specific information. The angiogrtam results helped me to determine how to proceed.

Yes, that is the correct link and it uses existing heart disease (positive Ca score) as one of the risk elements. Making the right changes in lifestyle can push risk way down. I spoke to my doctor yesterday at length and he was very supportive, wants me to stop worrying and that my risk of a cardiac event are very low considering my meds, diet, weight loss and working out daily. My mom started statin treatment at 40. I should've done the same, but just didn't know. What is done is done, all I can do is limit new plaque burden and enjoy life. It is hard to get it out of your mind completely, in fact, my doctor said he somewhat regretted having me take the test as the burden maybe outweighs the value of the information. I had plenty of risk factors already that were motivating me to change prior to the test results. There is a good argument to made for not putting this burden on asymptomatic patients. This article resonated with me, "The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment" Mandrola et al 2019 Am Fam Physician.