Living with high calcium score

70 Year old male. Stress test-Echo was negative but EKG had a minor abnormality. I requested a CTA. CTA was stopped due to high CAC score of 1090. LM 68, LAD 474, CX 197, RCA 350. No symptoms. Cholesterol has always been 160 on statins. Recent diet change and Cholesterol is down to 124. Cardiologist is out 3 weeks for a phone conversation to review. Have always been active outdoors and 30 min daily workout. 3 weeks seems a bit long to address my concerns.
Any thoughts

High calcium score does not mean artery is blocked. More so it’s calcified plaque which is not prone to rupture. It’s unstable plaque which is problematic. I am 65 years and has 560score in LAD. AHA guide line says CAT is not required for asymptomatic and blockage of 70% can be well managed with medication and diet. So not to worry at all.

questionofbalance,

You quote ... what is the quote from?

Anyone taking K2 supplements? How do you measure progress?

Interesting Danish study:
https://bmjopen.bmj.com/content/13/7/e073233
The effect of supplementation with high-dose vitamin K2 (720 µg/day) and vitamin D (25 µg/day) over 2 years was examined in the very recent Danish AVADEC (Aortic Valve DECalcification) Trial.21 Aortic valve calcification progression was non-significantly decreased.22 However, the supplementation appeared to slow down the progression of CAC, especially in patients with severe CAC (score>400). It also reduced progression of the non-calcified coronary plaque volume. Very importantly, the total number of cardiac events and all-cause death was significantly lower (unpublished data). As these findings were secondary outcomes, the results are only hypothesis generating and a confirmatory trial is requested.

Hypothesis
In a randomised setup, we test the hypothesis that supplementation with vitamin K2 (720 µg/day) and vitamin D3 (25 µg/day) in comparison to placebo will reduce the progression of CAC in patients with severe CAC.

What food lifestyle changes are cardiologists recommending besides the obvious. I've read that eggs, cheese, and beef are out. But pasture raised organic eggs have high omega-3. Some low-processed high end cheeses are high in vitamin K2, which is good (see below). I no longer eat red meat but used to eat mainly grass-fed beef which is also high in omega-3. Most studies generalize our foods which removes potential benefits from non-traditional foods. Do we need an update?

"Optimal Vitamin K2 intake is crucial to avoid the calcium plaque buildup of atherosclerosis, thus keeping the risk and rate of calcification as low as possible. Matrix GLA protein (MGP)—found in the tissues of the heart, kidneys, and lungs—plays a dominant role in vascular calcium metabolism."

what lifestyle changes did you have to make? thanks.

Lou,

It is said that CT angiograms are significantly blinded by high calcium deposit reflections... in a manner that prevents assessment of blockages, or thus was my understanding.

Did you have an echo with the stress test? With that much blockage EF would have been affected - or should have been?

Be aware of high CAC scores and ensure follow up testing is done with cardiologist. 6 years ago, I had a CAC score of 1350 and cholesterol of 180. Stress test showed no issues, but went on Crestor, Repatha to lower cholesterol. I continued healthy life style with regards to eating and exercise. I am 5' 10 and 175 lbs. After a year of continued borderline high cholesterol, I went on Ezetimbe which lowered my hereditary high cholesterol immediately. Took another stress test with no issues. This week, my latest CAC was 2214 which led me to have a CT angiogram which shoes 70-90% blockage in the LAD section of the heart. My advice is that CAC score and stress test are not enough to know for sure what is really going on inside.

I just looked at all my past records, first detected total chol above 200, 20 years ago! I was younger and more confident that I can reduce chol below 200, which I did. The cholesterol has been fluctuating between 180 and 22 over the past 20 years. For all the younger folks here, if you find total chol above 200 think about take statins sooner than delaying like I did.

My example - at 65 high CAC, then adjusted LDL down to 45-50, HDL stayed the same at 45-50, Triglycerides adjust down to 45-50.

Atovastatin and icosapent ethyl.

Took about 30 days for the changes to occur.

Stress with echo fine, peripheral ultrasounds fine, CT inconclusive due to image blooming from the calcium, cardiologist not recommending anything else at this, UNLESS pain of any sort, then would cath me.