I have a very high calcium score. What next?

I am on Medicare Advantage and my first month was something like $25, my second month was something like $125, then my third month and the months thereafter were closer to $1,000 because I hit the donut hole. Another problem with that is that it can effect my other meds to be higher because of what Medicare paid for those first two months. Anyway, I felt so bad. The reason you lose weight is because you are so nauseated and feel so bad you don’t eat. Not for me. For many reasons.

Thank you. What I understand is both Ozempic and Wegovy are GPL-1 class of medications. I am pre-diabetic and that is why my cardiolgist recommended ozempic. Ozempic helps with insulin resistance as well. From the research I have done from limited evidence out there, GPL-1 group of drugs may give an additional 20% cardiovascular protection, which is significant in my opinion. Yes, I am hearing that the side effects can be difficult to tolerate. I haven't started that yet.
My insurance told me if my cardiologist preauthorizes it, I will have to bay a big co-payment for the first month and afterwards, it will be minimal for a year. I am still trying to decide.

I haven’t heard of ozempic for cardio, but wegovy has been approved by the FDA for cardio and, therefore, even Medicare covers it, but you hit the donut hole very quickly and have large out of pocket until the next year. That was fine with me because it made me feel so bad I wouldn’t have continued taking wegovy after two months anyway.

I am a 67 year old with a CAC of 613. Pre-diabetic. BMI of 23. On Rosuvastatin 20 mg, Aspirin 81mg, and Amilodipine 5mgs daily
My LDL 36. Total Choletestrol 117, Triglyceride 64, HDL 67.
My cardiologist is recommending Ozempic 0.25 mg /week by injection for cardiac protection (not for weight loss or diabetes). My out of pocket expense will be $560 a month.
Anyone else got recommendation to start on Ozempic?
Any thoughts? Thank you

In the U.S., one in five people (20%) have the genetic allele, Lp(a). That's around 66.6 million people. There are 3 present drugs to treat Lp(a). There are 2 PCSK9 drugs Repatha and Praluent. Repatha can reduce LDL by 55%-75% and Lp(a) by 26.9%. Praluent can reduce LDL by 43-58% and Lp(a) by 26-30%. The 3rd drug an inclisiran drug, Leqvio reduces LDL by 40-60% and Lp(a) 20-30%. Does Ireland have access to these drugs? Pelacarsen, Ollpasiran, and Zerlasiran can reduce Lp(a) more effectively and may be available in 2-3 years.
Taking a high dose of statin does not decrease Lp(a) and can increase Lp(a) by up to 20%. Since Lp(a) is an independent factor no amount of exercise, diet or statin can reduce it.

There is really no point in repeating calcium scans if your score is greater then 0 no matter what a doctor suggests, your calcium is not going anywhere and your treatment plans won't change based on repeat scores. However if your score is 0 then I could see how repeat scans might be able to monitor future calcification issues.

Recall there is a relationship to statin use - statins increase calcification of cholesterol so those, for instance, that have a CAC test prior to starting statins, then start statins and have another scoring might be surprised how quickly their score increased - dependent on timeframe, I suspect.

So, statins increase calcification - which is good as this mitigates cholesterol from breaking off.

5 years. Now 6 years out.

I know, but not much to do about it. I h. ad an FFR done and have an FFR of 0.76 in my distal LAD (non stentable), but nothing else showed up. Cardiologist has offered to do a cath but as long as I'm asymptomatic going to hold off until I notice a problem or drop dead. So far I've made it 6 years with this philosophy. My CAC is multi vessel (mostly LAD and RM, with some LM and LCX). I'm afraid a cath might lead directly to multiple stents or a multiple bypass, and after watching my father die after bypass at 55 am a little gun shy.

I was tested at 65, result 240, no symptoms, felt great, I'm a regular runner --- and an angiogram showed a major blockage in an artery. You're not going to feel plaque buildup until something happens.