High Coronary Calcium Score: How do others feel emotionally?

My background has been stated perviously on this forum if you would kindly look back through the postings. And your own? Why are we asking this question? I dont seem to see that it has been asked of other forum users. Is this because you disagree with my opinion?

Also, I would suggest carefully reading the JAMA meta study, "March 14, 2022
Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment
A Systematic Review and Meta-analysis" to make your own conclusions on relative vs absolute outcome using statins.

For me, I find the paper significantly discouraging on the use of statins for preventative care. Of the two cardiologist I have met with since this paper was published, both vehemently dismissed its conclusions and have stuck with their stance that statins are a proven preventative treatment. The paper was published in JAMA Internal Medicine and heavily peer reviewed, so it is not a casual statement.

Here are some of the main highlights outline directly from the summary:

"Findings Twenty-one trials were included in the analysis. Meta-analyses showed reductions in the absolute risk of 0.8% (95% CI, 0.4%-1.2%) for all-cause mortality, 1.3% (95% CI, 0.9%-1.7%) for myocardial infarction, and 0.4% (95% CI, 0.2%-0.6%) for stroke in those randomized to treatment with statins, with associated relative risk reductions of 9% (95% CI, 5%-14%), 29% (95% CI, 22%-34%), and 14% (95% CI, 5%-22%) respectively. A meta-regression exploring the potential mediating association of the magnitude of statin-induced LDL-C reduction with outcomes was inconclusive.

Conclusions and Relevance The results of this meta-analysis suggest that the absolute risk reductions of treatment with statins in terms of all-cause mortality, myocardial infarction, and stroke are modest compared with the relative risk reductions, and the presence of significant heterogeneity reduces the certainty of the evidence. A conclusive association between absolute reductions in LDL-C levels and individual clinical outcomes was not established, and these findings underscore the importance of discussing absolute risk reductions when making informed clinical decisions with individual patients."

santefepete,

Thanks for making it clear it is your opinion.

As a way of follow-up, are you a scientist or medical professional?

Yes, that is my opinion. The JAMA meta study that came out in the spring of 2022 really showed that while the relative reduction in the use of statins towards cardiovascular disease looked promising, the absolute does not. This is a huge hot button for cardiologists, as it has been their frontline tool, and accepting that it is not working to the extent that they have believed, and it is a hard pill to swallow.
I remember when it was first suggested that H.Pylori was responsible for ulcers, not diet and stress! My god, the entire field lit on fire that they had been wrong for so long.
When I went symptomatic with my Celiac Disease in my early 30s, the common belief was that the disease was a rare 1 in 10,000, not the 1 in 100 we know today.
It is a hard thing to get doctors to accept change.
But check around and form your own conclusions. My diseases, Celiac and Sjogrens, puts me at an extreme disadvantage for tolerating medications, and therefore I need to be looking at alternative methods to lower my risk other than statins. The doc at Cleveland did agree that I have a horrible track record for medication tolerances and advised working towards an injectable. "Working towards" because it has to be proven to the health insurance company that normal means have been exhausted---proof of intolerance.

Try using a Mega Home distiller. Said to pull calcium out of heart.

santefepete,

Is this your opinion- "The argument for statins is getting thinner each year, especially given the side effects felt by many users."?

I am reporting back in on my 1444 CAC score from December of 2022, and my recent visit to the Cleveland Clinic for clarification of what this means to my health. I am a male, 63-years old, with no current symptoms of cardiovascular disease, but moderately high cholesterol levels as a chaser.

I was unable to get in at Mayo Scottsdale due to patient load, so that is why I went with Cleveland.
I will not mention the name of the doctor I met with, but he is one of the top interventional cardiologists at the Clinic. He had great knowledge, but I did not find him to be very engaging as a human.
The first bit of good news is that he said any score above 400 puts you into the "special" category that has proven out to result in 14% cardiovascular events over the next 10 years. Think about this carefully, as it also means that 86% of us will not have such an event over the next 10 years.
Under 400, but not zero puts you in at about 7%.
He did not recommend any further testing for me at this time since I seem to be exercising well and have no overt symptoms.
He said that even if there was a blockage, a stent would not prevent a heart attack, and he is the guy that goes in and cleans heart arteries out for a living. So there is no need to do preventative stent work, and it in fact might make things higher risk by having a man-made material present in the artery.
I asked him about the 2022 JAMA meta study on statins, and he said that they are still the frontline tool for cardiologists in preventing heart disease. But I ran the math, and it would reduce my absolute 14% risk down to about 9%. For me with Celiac Disease, the risk of using statins does not warrant the slight reduction.
I felt my trip was interesting. First, that the CAC score was a suggestion of poor cardiac health, but when you look at it on an absolute basis, perhaps not that much risk. So as many of you have questioned by your own experience, is the CT Heartscan worth even doing? I am not sure that it is.
Second, there seem to be few good tools for cardiologists to really help with heart health. The argument for statins is getting thinner each year, especially given the side effects felt by many users.
Third, is using a $1K a month injectable going to reduce the risk enough to warrant the cost or is it more important to reduce risk by weight lost, diet and exercise? Nexletol is likely the state of the art anti inflammatory and cholesterol reducing drug at over $700 a month.
For me, Celiac Disease and Sjogrens Syndrome are my primary diseases. My Celiac Disease is well managed through diet, but my gut health will never be normal, and it makes tolerating something like statins virtually impossible. But it is the Sjogrens and its inflammatory nature that likely puts my heart at highest risk. I already gave up red meat completely seven years ago, and it made a considerable difference.
I would have to go with weight reduction and A1C management as my biggest priority for heart health at this point. I think it outweighs the benefits of cholesterol reduction by drugs.
It is still a work in progress, and that is just my general reaction after going to Cleveland. I feel relieved by the news, but not out of the woods on taking action. My overall risk is about 7x higher than the general population of having a cardiovascular event, and I would like to lower that risk. But living in fear does not seem to be warranted at 14% over the next 10-years. We are all going to die from something. I just want to put that off as long as possible and have a quality life in the meantime. Just worrying about a CAC score seems to be more harm than good.
Pete

Very helpful. I have 3600 cac but very good stress test result.
My internist agreed with me that angiogram wasn't warranted, cardiologist said standard of care was to do nothing more but statin and aspirin, although cardiologist said i should consider angiogram to see if there was a potentially bad area.
I am staying pat for now.
Did Cleveland clinic doc give you any other things you should do?