1. < Heart & Blood Health

VERY HIGH Coronary Artery Calcium Score

Posted by polar @polar, 4 days ago

I'm a 69-year-old, very active (until recently) male. Have a good diet, non-smoker and casual drinker. I had a health episode a couple of years ago that resulted in testing that revealed signs of a past Cerebrovascular accident (CVA), Left carotid stenosis, Coronary Artery Disease, Occlusion of the right vertebral artery and extremely high Coronary Artery Calcium (CAC) Score (total 3536). I have had high cholesterol for quite some time, but it was always thought that it wasn't a problem due to my high HDL and low ratio. These findings resulted in a couple of stress tests and further imaging. The stress tests have been very, very good, showing a strong heart. I have been on a couple different statins (Atorvastatin and Rosuvastatin), both of which wreaked havoc with my muscles and joints. Most recently I have been on Praluent. My current Lipid panel showed a Total Cholesterol of 180, Tri of 116, HDL of 94 and LDL of 63. I have also had a Sterol test that has come back negative. I have been off all cholesterol meds for a short time due to an unrelated health issue but am looking at being able to go back on them shortly. Not sure what I am asking, other than suggestions that anyone may have for any additional testing and cholesterol medication to consider without just throwing a dart at the Cholesterol Dart Board. The high CAC has gotten into my head. Appreciate any thoughts.

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betsya | @betsya | 4 days ago

Get your LPa test done. learn about how high LPa effects your heart.

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1 reply
polar | @polar | 4 days ago
In reply to @betsya "Get your LPa test done. learn about how high LPa effects your heart." + (show)
@betsya

Get your LPa test done. learn about how high LPa effects your heart.

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Thanks, i've been reading about that and is on my list for my cardiologist.

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1 reply
bitsygirl | @bitsygirl | 3 days ago

I had a surprisingly high CAC score (600-ish - 98% for gender and age) after decades of exercising regularly, normal weight, reasonably good diet and not alarming lipids (though not optimal). I was able to get a coronary CT angiogram. It measures roughly the percent blockage, though not as well as a traditional CT angiogram. For me it showed no blockages greater than 25-50%. It doesn't mean I am home free, heart attacks occur from non-obstructive plaques, but it has been real peace of mind regardless. It also showed that the plaques did not contain some features that they can detect that are associated with a higher likelihood of rupture. Some doctors seem to be willing to prescribe this and some don't. I am not sure why. The cardiologist I was working with at the time also had a family history so he may have had more empathy. There was some plaque in the LAD too, so that may have been a factor.

I am curious, do you have a family history? I have learned that many doctors look at slightly off lipid numbers in otherwise healthy people and dismiss them despite the family history. It seems like a mistake.

FWIW, I also seem to have some side effects from Rosuvastatin. It caused muscle soreness and had a negative impact on my ability to work out. I am trying Atorvastatin currently. Only been a few weeks.

I thought of one other thing. You may have high lipoprotein(a). This is genetic and not all doctors know seem to know about it. Statins don't help with this I believe. PCSK 9 inhibitors lower it some. There are drugs in testing now for people with very high lp(a). Given your high CAC score despite reasonable lipid numbers, you might want to at least get tested. (Though again, not much they can do about it right now, so maybe it would just be another worry.) Mine was high, but not crazy high -- maybe 85-ish percentile?

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1 reply
george7856 | @george7856 | 3 days ago

do u have any other arteries blocked other tha the right one?

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polar | @polar | 3 days ago

Not occluded, but I do show stenosis in the left carotid artery. Alarming CAV score in the LAD.

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polar | @polar | 3 days ago
In reply to @bitsygirl "I had a surprisingly high CAC score (600-ish - 98% for gender and age) after decades..." + (show)
@bitsygirl

I had a surprisingly high CAC score (600-ish - 98% for gender and age) after decades of exercising regularly, normal weight, reasonably good diet and not alarming lipids (though not optimal). I was able to get a coronary CT angiogram. It measures roughly the percent blockage, though not as well as a traditional CT angiogram. For me it showed no blockages greater than 25-50%. It doesn't mean I am home free, heart attacks occur from non-obstructive plaques, but it has been real peace of mind regardless. It also showed that the plaques did not contain some features that they can detect that are associated with a higher likelihood of rupture. Some doctors seem to be willing to prescribe this and some don't. I am not sure why. The cardiologist I was working with at the time also had a family history so he may have had more empathy. There was some plaque in the LAD too, so that may have been a factor.

I am curious, do you have a family history? I have learned that many doctors look at slightly off lipid numbers in otherwise healthy people and dismiss them despite the family history. It seems like a mistake.

FWIW, I also seem to have some side effects from Rosuvastatin. It caused muscle soreness and had a negative impact on my ability to work out. I am trying Atorvastatin currently. Only been a few weeks.

I thought of one other thing. You may have high lipoprotein(a). This is genetic and not all doctors know seem to know about it. Statins don't help with this I believe. PCSK 9 inhibitors lower it some. There are drugs in testing now for people with very high lp(a). Given your high CAC score despite reasonable lipid numbers, you might want to at least get tested. (Though again, not much they can do about it right now, so maybe it would just be another worry.) Mine was high, but not crazy high -- maybe 85-ish percentile?

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Thanks for the note! Atorvastatin was the worst for me, making every step extremely painful. Interestly, just prior to seeing your message I sent my cardiologist a note about having a CT Angiogram done. I'll see how he responds. Good luck with your journey.

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nonna2four | @nonna2four | 2 days ago
In reply to @polar "Thanks, i've been reading about that and is on my list for my cardiologist." + (show)
@polar

Thanks, i've been reading about that and is on my list for my cardiologist.

Jump to this post

I received a free test kit to check my Lp(a) from familyheart.org. I did a finger prick on Wednesday, mailed it off the same day, and had my results by the next Tuesday. Thankfully, my Lp(a) was in the optimal range. Now I’m just waiting for my echo stress test on February 11 to see what it reveals.

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moralesjmoe9 | @moralesjmoe9 | 8 hours ago

Did you get muscle pain while taking praluent ?

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1 reply
polar | @polar | 8 hours ago
In reply to @moralesjmoe9 "Did you get muscle pain while taking praluent ?" + (show)
@moralesjmoe9

Did you get muscle pain while taking praluent ?

Jump to this post

I took Praluent for about 3 months and then took a statin break when I ruptured my achilles and had a brain bleed from a fall. No way of knowing if statins had an impact on my achilles or just one of those things, but took a break on meds to see where my head was at. Getting back to taking Praluent this week. To answer your question, Praluent was prescribed because I seem to be sensitive to statins and Praluent didn't appear to affect my muscles as of yet. Time may tell.

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