I have a very high calcium score. What next?

doing an angiogram to me is not over kill. I did a doppler test but the doctor wanted to have more specific information. The angiogrtam results helped me to determine how to proceed.

Thanks for letting us know.

Well everyone is entitled to take whatever actions they want when receiving news of a CAC score, getting cardiac catheterization, stress testing, coronary angiography etc if you're asymptomatic and making recommended dietary and lifestyle seems like overkill to me, as referenced by the study.

The study:” No immediate or long-term benefit to such individuals from either stress testing or coronary angiography has been documented in the literature." I see a lot of folks here running to do these things after getting a CAC score and it's really not needed,…”
I don’t agree with that.

I'm a little confused as what you said is what the study supports. They are talking about asymptomatic individuals; such cases, with suggested immediate statin use, dietary and lifestyle changes and the suggested changes in LDL-C, hs-CRP inflammation etc are needed in asymptomatic individuals.

I don't agree with the reading. If your CAC is 400+ It is not necessary to have the stress and EKG tests but the risk of a stroke or heart attack exists. It will exist forever although you can stabilize your condintin by improving life style (diet, exercise + statins). I am asymptomatic but my score is close to 1600. Numbers don't lie. My liver produces too much cholesterol.
As far as the angiogram the imaging of the blockage in your arteries are facts as well. I didn't run to the angiogram believe me but with a score like the one I have I needed to know the exact blockage percentage on my LAD.

That study was released in 2019 I believe so it's fairly recent and most likely still the standard. The most important thing it states is "referral for stress testing and cardiology consultation should be delayed until evidence of unstable angina exists. No immediate or long-term benefit to such individuals from either stress testing or coronary angiography has been documented in the literature." I see a lot of folks here running to do these things after getting a CAC score and it's really not needed, according to that study anyways. Since you are over 400 however they do suggest getting your LDL below 70 along with the dietary and lifestyle changes for everyone else under 400.

I typed in "Arizona Heart Risk Calculator" and the first citation is: https://heart.arizona.edu/heart-health/heart-attacks/heart-disease-risk-assessment

I tried to find the Arizona Risk Calculator.. do you have a link? I’ve been living this for 18 months and like most of you there is always this dark cloud hovering. I’ve made the changes, now I’d like to be optimistic of the outcome.. at 63 with a cac of 2418.. it sometimes seems overwhelming. If someone has the link that would be great.

@neilyounger Thanks for those links, it really is startling. I suppose it is positive that many of the smokers quit if that is the only thing that they end up changing. Do you know of any articles that quantify risk reduction and how one would benefit by taking action and also starting statin therapy? I found a risk calculator on the Arizona State University heartseries.org site that was helpful to reassure me that making changes does have a huge impact on your longevity. Basically, cutting risk from very high (>20%) to low risk (3-8% chance of heart attack in 10 years). I think I can live with those numbers at 55yo and its worth it to do whatever I can to keep the risk in that range.