49 yo male 1900 calcium score normal stress test and echocardiogram

Hi @pkoutou

Everything I've read states that the CAC scores are very accurate. I'm somewhat in the same boat as you. I'm 61 and recently found out my CAC was 2534. And like you, my echo and nuclear stress test are all good. I'm completely asymptomatic. No real family history of heart disease outside of my father dying of a heart attack at 84.

I was put on 20mg of Crestor when I got my CAC score and outside of that and watching my diet (although not as strict as I could lol), I really haven't changed anything in my life. I still walk about 5 miles a week, workout, etc.

What actions has your cardiologist given you? For example, did he tell you to repeat the echo every "x" years?

I wonder what your cardiologist has recommended as far as treatment other than diet and exercise. I had a CAC of almost 1600. My LAD artery showed a high score itself. All tests done and came out good. Imaging showed a little dark spot so Doc. suggested an angiogram which i was trying to avoid. I am asymptomatic at 64 yrs. old. My PCP initially put on Rosuvastatin 10mg but the cardiologist increased to 20 mg. I had the angiogram (via the groin area, no other choice offered). It came out to the LAD mid section being blocked. Interventionist said "You are borderline" which later I learned was 60/70% blockage. At that moment I decided NO stent. Now is just about dieting, eating well, increasing cardio exercise. I can always go back and get a stent. Hopefully my blood tests keep coming good, My LDL was 125, went down with statins to 72 but cardiologist wans to bring it down to 55. The secret: try as much as plant based diet as I can.

@pkoutou Good morning. I understand you are taking Crestor. Haven’t you noticed if your blood sugar levrls have increased with this medicine. I haven’t started it yet since I am following a strict diet but I have a friend who developed diabetes because of taking Crestor.
Any information will help. Thank you

naiviv,

Here's a summary article that addresses the occasional increase in A1C associated with various statins - and the variability of patients.

From additional reading, those folks with extremely high A1C and borderline diabetes may get a nudge into diabetes with some statins under some conditions - but, apparently, statins don't cause diabetes in folks with normal blood sugar levels.
https://www.ccjm.org/content/90/1/53#:~:text=Overall%2C%20in%20statin%20users%2C%20hemoglobin,compared%20with%20all%20other%20statins.

Thank you.

So CaC score 1900
Echocardiogram gram is great
Stress test couldn’t be better
EKG I’d fine
Bp 120/70
Resting HR 84
Total cholesterol is 80 under new meds..
A1C 7.4
Super comfuded. Should I ask for a retest on the cac test. Maybe a false positive? Anxiety is next level. Father died of a heart attack in 92 ath the age of 48 but did not take care of himself. Never went to Dr and smoked 3 packs of cigarettes a day.

@alaskat

Hello,

When I met with my cardiologist, I went over my diet the last 10 years (rarely any red meat, mostly pork, chicken and fish, a fair amount of vegetables, and my vices of sweet tea and chocolate 🙂 I mentioned I had been a vegetarian the past 6 months). I also told him that I work out doing sandbag training 3-4 times a week and walk around our neighborhood roughly 5x a week (a mile loop).

He didn't mention any specific changes except increasing my rosuvastatin from 10mg (recommended by my primary physician) to 20mg and check back in 6 months. He also suggested taking a daily baby aspirin, but after reading about the possible side effects, I chose not to follow that advice. My decision was based on risk and the fact the both my nuclear stress test and echo cardiogram came back normal (i.e. no indication of blood flow problems). I'm not telling anyone to follow my lead. This is definitely an individual choice. Having said that, I have started carrying four chewable baby aspirin (the equivalent of one adult strength aspirin) with me just in case (just to have them handy should I start feeling chest pain. I do realize it may hit so suddenly that I wouldn't have time to take them, but in case I do, they're there with me). Chewable aspirin has been shown to get into your blood stream a few minutes faster than the non-chewable form. Here I'm referring to the orange baby aspirin many of us grew up with.

The main side effects of daily aspirin are (taken from the Mayo Clinic website, but can be found elsewhere as well):

Stroke caused by a burst blood vessel. While daily aspirin can help prevent a clot-related stroke, it may increase the risk of a bleeding stroke. A bleeding stroke also is called a hemorrhagic stroke.

Gastrointestinal bleeding. Daily aspirin use increases the risk of developing a stomach ulcer. If you already have a bleeding ulcer or gastrointestinal bleeding, taking aspirin may cause more bleeding. The bleeding may be life-threatening.

Allergic reaction. If you're allergic to aspirin, taking any dose of aspirin can trigger a serious allergic reaction.

Here's a breakdown of my CAC score (2534 overall):

Left main artery - 36
Left anterior descending - 665
Left circumflex - 194
Right coronary artery - 1639

Like you (I'm 61), I'm completely asymptomatic. Here are my numbers (first column are my numbers from March 2023 ,and the second column is after 6 weeks of 20mg Crestor/Rosuvastatin. Pretty remarkable changes:

Tot. cholesterol 221 137
Trig. 69 48
HDL 83 78
VLDL 12 11
LDL Chol 126 48

I agree as there are divided opinions and risks about taking baby aspirin with statins. It can cause ulcers and internal bleeding. Definitely worth to ask my cardiologist. Thanks.

So, high CAC, high A1C, high heart rate?

Total cholesterol below 80? This seems pretty low ...

Baby aspirin article from Mayo ... https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/daily-aspirin-therapy/art-20046797

Another person with high CAC score here despite heart healthy lifestyle. Normal lipid profile for years. EKG and nuclear stress test came back normal. I had a CT coronary angiogram because LAD score was high and the CT angiogram showed that the CAC score was correct. There was plaque in multiple arteries but none caused more than 50% stenosis. Hence the normal stress test I guess. My mother had a quadruple bypass at about my age but I didn’t think it would be my story because she didn’t take care of herself and I did/do.

Guess my point is that it seems very unlikely that your score is wrong. I had the same hope/question but it wasn’t wrong. Yet with statins and a heart healthy lifestyle, according to my cardiologist, the progression can be stopped. (Your CAC score may actually go up on a subsequent test because the plaques calcify but their volume does not increase.)

Good luck with your journey!