CAC score in 95th Percentile - Next Steps?

pumaguy,

So, I usually ask non-medical professionals why they feel qualified to determine what is appropriate to their circumstances?

Did you answer the questions about taking a statin or aspirin?

Dear Question, lots of great questions.
No , I can’t tolerate statins. I take Zetia instead.
Finding a good cardiologist can be a daunting task. By “good” I mean one who treats the patient, noi the numbers. Who considers invasive procedures a last resort not the first. Who is a partner not a single-minded critic. Who is not so severely overloaded that they have time to talk. Cardiologists are taught a completely different bedside manner as in none.
I don’t think there is a noninvasive test for soft plaque.
Computed tomography (CT)will register the “glow” of calcium a tracer of (hard) plaque.

CT has been a blessing and a curse to many.
Oh yes, the risks of cath. My reading tells me the risks are bleeding, stroke, heart attack
And a quick trip to
a CABG ( coronary artery bypass graft)surgery. Without life affecting symptoms, those are too many risks in my humble opinion.
Everyone must decide for themselves.

Take care.

cianci, no statins...Zetia, Yes to aspirin. Also started a anticoagulant, despite bleeding issues.

Diet is nothing special. Have reduced red meat. The most important factor is intermittent fasting. It's a wonderful practice with MANY paybacks like weigh loss, glucose control and much diminished joint pain.

BP has always been high. Pretty good control now. Cholesterol unremarkable although triglycerides always high all my life.

Thanks for the useful answers. Agreed about the CT being curse or blessing. I thought my life was over at first.
Zero is goal.
100 bad ....>300 critical. So 700 is beyond critical. Told to double my statin, take aspirin (which I stopped since it bothered me), and find a cardiologist. Do you exercise? What should you and shouldn't you do?

From what I'm finding, you should exercise. Keep moving. If hard time breathing get to ER. Probably need a stent.
Otherwise, slowly increase your workouts.
My goal is to be in shape for the probably stress test in a month. So far I don't have symptoms. My brother got a stent 20 years ago after he was turning blue playing racquetball.
But then you hear of people feeling fine and dropping from a clot. But doing nothing will kill you fer sure.

I'm eating very good food (mediterranean diet without any breads, salmon, sashmi, vegetables w/oil oil, many salads (olive oil/garlic/lemon) and beans, and some shellfish). Lost 30 lbs. Another 15-20 to go. Covid, deaths in family, work stress beat me up the past few years. Feels good to be getting back into shape and this shock of 700 is pushing me harder.

There should be guidelines once you receive the scores.
This forum helps. Thank you.

Yes, intermittent fasting is the only way I seem to lose weight.
Why do you need asperin and an anticoagulant? Similar to a blood thinner?
What is the test to determine if anticoagulant needed?
Were you told to limit your workouts?

This is just one source, and your numbers aren't terrible, if I am correct. But they are in the range, to my way of thinking, where I would ask the pointed question to my GP or a cardiologist...should I be doing something to improve those values or the ratio.

One other think came to me: in some medical circles, they are more concerned over triglycerides. There is new research suggesting that cardiologists would be as well off, or better, to look to those numbers because they correlate strongly with atherosclerosis.

my cardiologist doubled my statins also from 20 to 40 but my stomach couldn't tolerate it. i didn't think he was taking it seriously enough so i got another cardiologist after asking around. he does not take insurance but i'm serious about this so i pay out of my own pocket and the insurance covers some. fortunately, i can afford this.

he gave me an echo cariogram and a nuclear stress test and said my blood flow was just fine. i think that's the key. he said there's no way of knowing if the plaque is on the outside or inside the arteries and, as others have said, the scan measures the hard plaque, not the soft plaque and the soft plaque is the killer. furthermore, i've been taking statins for at least 15 years and it's partially designed to harden plaque at least as i understand it.

in sum, after reading all these books about heart healthy living, i've decided to eat right, exercise at least 4 x a week, and take a statin plus a PSK9 inhibitor. that's an injectable and they are remarkable in bringing down LDL cholesterol. Mine now is at 5 which I'm told is too low. This after taking Repatha (the PSK9 inhibitor) and 10 mg of statin for a year. Now I'm cutting back to 5 mg at doctor's orders. My overall cholesterol sank to 77!

I also swim 3x a week and walk most every day and lift weight once a week, mostly. i don't always have time for that. it's important but low on my list of priorities.

BTW, Repatha is very consumer friendly and likely you'll be able to get a $5 co pay coupon if you go on their website (PS I am not affiated with them in any way).

good luck, hope this helps .

Good stuff, writer!!

You have really worked this - did you discuss Vascepa (icosapent ethyl) with your doc?

hi- My brother passed away at 57 in july. He was very fit and cycled daily and had no health issues. He had a cardiac arrest after a hard workout. It shocked us all. Our family got checked for heart issues. We all got an angiogram and my result came back EXACTLY like your. Calcium score of 30-95%. I am 49, have normal blood pressure and cholesterol is ok. My cardiologist told me he believes in prevention and put me on a statin and baby aspirin. He told me the plaque build up is generic and not lifestyle driven and if I don't get on statin I could have the same fate as my brother in 7-10 years beacuse it will just continue to build. I would get a second opinion and find a dr who beleive in prevention!

writer,

Did you discuss icosapent ethyl (Vascepa) with your doc?