I have a very high calcium score. What next?

When I got my test results back I got kinda freaked out because my CAD score was 595 and anything over 300 was considered high risk. Until I joined this group, I had no idea it was possible for scores to be over 1000 and 2000. I am 68 and asymptomatic, but my dad died of a heart attack at my age, and my brother had a heart attack at 44 (heavy smoker and alchoholic, and I am neither) My lipids are pretty good on 20 mg Rosuvastatin and ezatimbe, except for my Lipoprotein a which is greater than 600nmol/L, which statins don't affect. My cardiologist wants to put me on Leqvio which targets Lipoprotein a, but my insurance won't cover it, plus it seems like it's still in the experimental stage and there doesn't seem to be proof at this point that it actually lowers risk of heart attack or stroke. My cardiologist also says there is a new one that will be available in about a year, but again it will take time to get risk outcome data. I have a tendency to get bad leg cramps that may be attributable to the statin, and I'd love to at least reduce my dose. Sometimes it seems like there's not much point in all these medications, because they can't prove that they lower risk, but the doctors have to do SOMETHING when your scores come back high. So far I am enjoying this forum, and find it somewhat reassuring, so I'll keep reading!!

When I got my test results back I got kinda freaked out because my CAD score was 595 and anything over 300 was considered high risk. Until I joined this group, I had no idea it was possible for scores to be over 1000 and 2000. I am 68 and asymptomatic, but my dad died of a heart attack at my age, and my brother had a heart attack at 44 (heavy smoker and alchoholic, and I am neither) My lipids are pretty good on 20 mg Rosuvastatin and ezatimbe, except for my Lipoprotein a which is greater than 600nmol/L, which statins don't affect. My cardiologist wants to put me on Leqvio which targets Lipoprotein a, but my insurance won't cover it, plus it seems like it's still in the experimental stage and there doesn't seem to be proof at this point that it actually lowers risk of heart attack or stroke. My cardiologist also says there is a new one that will be available in about a year, but again it will take time to get risk outcome data. I have a tendency to get bad leg cramps that may be attributable to the statin, and I'd love to at least reduce my dose. Sometimes it seems like there's not much point in all these medications, because they can't prove that they lower risk, but the doctors have to do SOMETHING when your scores come back high. So far I am enjoying this forum, and find it somewhat reassuring, so I'll keep reading!!

I tried Prluent and my LDL plunged as did overall cholesterol numbers. of course then my insurance stopped paying so I’ve switched to Repatha which is I’m told similar. Whatever you do, I’ve listened and read a lot of info about this including this board which I too enjoy. From what I’ve discovered, the best treatment is a combo of statins and a PSK9 inhibitor like Praluent or Repatha and I believe Leqvio is in that category. I’m a journalist and am soon going to write an article about the stress caused by people having this test. I wish I had never taken it. It’s changed my outlook about my own health and I’m not really sure it means anything. Statins, which I’ve taken for years, are designed to calcify plaque so it’s not dangerous. So does the fact that my score is 642 (my wife’s is 0 and she has not taken statins) mean I’m somehow at risk? I’m not convinved.

I tried Prluent and my LDL plunged as did overall cholesterol numbers. of course then my insurance stopped paying so I’ve switched to Repatha which is I’m told similar. Whatever you do, I’ve listened and read a lot of info about this including this board which I too enjoy. From what I’ve discovered, the best treatment is a combo of statins and a PSK9 inhibitor like Praluent or Repatha and I believe Leqvio is in that category. I’m a journalist and am soon going to write an article about the stress caused by people having this test. I wish I had never taken it. It’s changed my outlook about my own health and I’m not really sure it means anything. Statins, which I’ve taken for years, are designed to calcify plaque so it’s not dangerous. So does the fact that my score is 642 (my wife’s is 0 and she has not taken statins) mean I’m somehow at risk? I’m not convinved.

I tried Prluent and my LDL plunged as did overall cholesterol numbers. of course then my insurance stopped paying so I’ve switched to Repatha which is I’m told similar. Whatever you do, I’ve listened and read a lot of info about this including this board which I too enjoy. From what I’ve discovered, the best treatment is a combo of statins and a PSK9 inhibitor like Praluent or Repatha and I believe Leqvio is in that category. I’m a journalist and am soon going to write an article about the stress caused by people having this test. I wish I had never taken it. It’s changed my outlook about my own health and I’m not really sure it means anything. Statins, which I’ve taken for years, are designed to calcify plaque so it’s not dangerous. So does the fact that my score is 642 (my wife’s is 0 and she has not taken statins) mean I’m somehow at risk? I’m not convinved.

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.

I sometimes wonder what would have happened to me if I hadn't take this test and gone on Crestor. Would I have died in five years or 20 years if I hadn't gone on statins? I'm healthy otherwise, asymptomatic, still do sandbag training at 61, walk a mile around the neighborhood at least 5x a week and no family history of heart disease except my father dying at 84 from a heart attack. My nuclear stress test and echo both came back normal. I sometimes question if this was a good thing or not. Guess there's no real way to tell.

I tried Prluent and my LDL plunged as did overall cholesterol numbers. of course then my insurance stopped paying so I’ve switched to Repatha which is I’m told similar. Whatever you do, I’ve listened and read a lot of info about this including this board which I too enjoy. From what I’ve discovered, the best treatment is a combo of statins and a PSK9 inhibitor like Praluent or Repatha and I believe Leqvio is in that category. I’m a journalist and am soon going to write an article about the stress caused by people having this test. I wish I had never taken it. It’s changed my outlook about my own health and I’m not really sure it means anything. Statins, which I’ve taken for years, are designed to calcify plaque so it’s not dangerous. So does the fact that my score is 642 (my wife’s is 0 and she has not taken statins) mean I’m somehow at risk? I’m not convinved.

I am in the same boat, 60 yr. Old female, have always been healthy, CAC of 585, (472 in my LAD) of my total score, statins have not agreed with me at all, I am doing red yeast rice 600 mg/day, my chol. numbers have decreased in 6 weeks, cholesterol is 201 down from 238, LDL 126, down from 151, I walk 36 miles a week and quit smoking 8 weeks ago, and cut out diary. I wish I had never taken the test, I live in fear of a cardiac event daily (certainly no way to live). I asked my cardiologists if we should do a cath or stent, he said no, Cath’s are too dangerous and no symptoms to indicate needing a stent, sadly when you have symptoms it might be too late. There seems to be a big void in testing AFTER the calcium test to know if you are actually okay. They don’t want you to repeat the test, but they say the score can only get worse, it cannot decrease no matter what medications you take. The scary thing is that you can hopefully keep it from progressing but if you are already at a “high risk” level you just feel like a walking time bomb, there has to be a better way to test patients at high risk levels on a monthly basis so that we don’t live in fear. Does improving your numbers really help? I have seen where people have normal Chol. numbers but have high CAC scores, and no real explanation. Also, testing for hard plaque versus soft plaque would be helpful after you get a high CAC score. I really enjoy this forum as I find it very informative hearing from others that are enduring the same health issues. Has anyone had good results from the red yeast rice?