I had CAC score of 0 thru my 50’s. Went up to 150 by early 70’s. Passed a nuclear stress test and got an all clear. Then suffered major MI while on treadmills at the gym. Always in good cardio/ resistance training shape. I had a ruptured plaque in a major cardiac artery. Being a retired firefighter/paramedic I got my ass into the ER within 10 minutes. Only thing that saved my life
Good for you. I think so many people have them and think they will just sit it out or "it will pass" and don't get themselves to the ER. I hope this inspires you: my mother had emergency bypass surgery in her 70's, and a valve replacement at age 93. She just turned 100! She was fishing, driving, gardening, etc. well into her 90's, and lived alone until 97. The only time she goes to the dr. is once a year to the cardiologist and opthamologist.
@@jeannepeters88362 emergency stents with removal of the clot. The ER staff was amazing! They recognized the probable MI and had me up in the catch lab really quick. They saved my life for sure. The nuclear stress test 2 weeks earlier didn’t detect any problems??😮. Go figure!
Family history of heart disease. Calcium score and my father (5 stents) asking me to get checked out led to a calcium score test recommendation from my primary care (Dr. Adam is awesome btw) and it likely saved my life. I had no symptoms and had the truck packed for a camping trip. CACS score was 1,441 (! Yes out of 0-400), stress test mild blockage, heart cath showed 3 blockages (100/80/50), and now I am in cardiac rehab from a triple bypass and I’m doing well thanks to the love and support of so many people. Several colleagues have gone for calcium tests and all have come back good - God bless. Please do this test if you have a family history, high cholesterol, high blood pressure, or any concerns about your heart health - I had no symptoms (age 53).
@EEEBA1 zero score doesn't mean you are safe, but that you are more likely to be safe. High score means you definitely have a problem. Although, you'd find out just as easily from a stress ECG. (I did, and only with 40% blockage.)
@gineering I had a Calcium score of 1400 a few months ago ordered by my primary. I had a CTA done last week of my heart and a ultra sound done a week earlier. I have no coronary blockages. Echo Cardiogram showed no issues with blood flow either or the structure or mechanics of my heart. I was shocked. I dont think my cardiologist was shocked but I think he was not expecting those results. He said my calcium is there but distributed through my heart and he talked about other things etc concerning calcium. Im 59 years old.
@@sascha6176 Hi, I have not had a calc score done since that first time several months ago. I am seeing my cardiologist in about 3 months. I will bring this up. I have a feeling he will say there is no need for another one. But I have lost about 30lbs since that calc score and i am eating better and exercising. It would be interesting to see what it is at this point.
I’m 71 and about five years ago had a CAC of 1700. My cardiologist upped my statin dose from 10 mg to 40 mg, and I remained on a baby aspirin a day. A few months later I also had a CTA. As of today, I have remained on the same medication and I am and have always been asymptomatic. One variable that I think came into consideration is that I’m also an avid runner and have been for some 40 years. There have been studies that show plaque being stable in runners. In addition, an extensive Cleveland Clinic study has shown that statin and aspirin have been just as effective as stents at preventing serious coronary outcomes in asymptomatic people. So far, so good, my cardiologist has more than once said that my plaque is stable. I’m certainly hoping it stays that way! Thanks for the great video!
We pay the doctors, but they can’t explain it like this. I am on my third doctor only because I’m looking for a doctor to explain to me like what I just heard on this video.
61 YO. Had a test done at 58. Score - zero. Had the test done on a road trip 500 miles from home. Was on a bicycle vacation. The techs weren't supposed to say anything but they were chuckling and told me nothing to worry about. Got the official results a few weeks later. Best $100 I've spent for peace of mind. Probably do it again one of these days.
@venicebeachsurfer I train for bicycle races, so burn a good bit of calories, pretty carb heavy. Rice, fruit, lots of eggs, couple of slices of bread daily, peanut butter. No alcohol or coffee.
My health has greatly improved since switching to less (unhealthy) carbs, more ( healthy ) fats and (least toxic) fruits , but this video is a home run that we all needed when it comes to knowledge of cardiovascular health. Bottom line is, health is all about balancing your diet that is based on organic and least toxic whole foods and exercise. Like they say, " you don't stop moving when you get old, you get old because you stop moving".
I feel much better after watching this video. I am a 65 year old male and have been on a statin for 20 years. I had a CT scan last week and my score is 1350. I am headed to the cardiologist in July. I would prefer a lower score of course, but it is good to know that this could be a good thing in my case. Hard stable plaque. Thanks.
High calcium low magnesium and vit b1.. or acv…just do your research…there’s chronic deficiency of other nutrients to balance body function…change diet
I've always had good cholesterol levels and I'm now 68. My intake of sodium was above normal but doctors always said that since I didn't have high blood pressure it was fine. Last year my doctor came out of the blue and recommended a CAC just to see where I was at. The score came back over 500 and I immediately went on a statin. Now that I've done some research, sodium also appears to be a big factor with getting calcification. I now feel that all those years that I was being told not to worry, I should have been taking steps to reduce my sodium intake. Now I feel like I'm in a could-a, would -a should-a situation. I had a treadmill stress test and blood flow was good. Now I'm really confused. How can I have a high CAC but with good cholesterol levels and blood pressure?
@@thomasryan5681 I highly recommend reading, Dr. Caldwell Esselstyn’s book, prevent and reverse heart disease. Also all the TH-cam videos that he speaks on.
I recommend looking into a whole food plant based diet with no added sugar, oil, or salt. Read Dr Esselstyn’s book .. Prevent and Reverse Heart Disease.
Thanks Gil - for a wonderful explanation. I have a friend who is on a keto diet (long term) , heavy smoker but also exercises regularly - at 57 years - has a CAC of 0. On the other hand, I , also 57, a vegetarian, with normal TRGs and lipid profile, but overweight and don't exercise regularly, have a CAC of 10. I guess, both of us have to make lifestyle changes and not rely exclusively on the CAC. Thank you very much - I really like your channel and explanations. I am a neurosurgeon and deal a lot with brain haemorrhages and similar conditions - the most common underlying theme I find amongst affected patients is a combination of obesity, diabetes, hypertension and lack of exercise....and, increasingly encountering patients in their early 40s with brain strokes...
There was a recent study showing a big link between diabetes and heart disease. People with diabetes are 2 to 4 times more likely to die from heart disease.
I lost weight on Keto but it really shot my Triglycerides up I usually run in the normal range and even have over cholesterol around 180. LDL always been 75% of it which isn't good. That Keto diet sent my triglycerides from 120-130 to over 300 so I cut high saturated fats from daily to every few weeks at most.
Coloestetol numbers mean nothing by themselves. Also, arteries must already be damaged for plaque to accumulate. So a high ldl is not a lone indicator of issues.
I had a score of 1188, mostly in the widowmaker artery, and was sure I was going to die any minute. That was 11 years ago and so far I’m still alive and no “events” but the day’s not over yet.
@@patrickbercini2718 They put me on a statin. and a blood pressure med. Many years later I had a doppler ultrasound test which they said was normal. For what it’s worth, I take two kinds of vitamin k2, one from natto and one from animal sources, and ride my bike most days.
Can t say enough about your excellent content, well-explained with important guests and giving the most important information to viewers. I really admire your work and the person you are. All the best Gil...
I believe what most people would be interested in is a inexpensive and reliable way of judging and following their heart health over time. The only way I see of doing this is with a CIMT test repeated every few years. It's cheap, no radiation, isn't intrusive and available everywhere. How about a video discussing how people can track their heart health using inexpensive tests? And in particular the benefit of the CIMT over other tests.
CIMT is available everywhere? I had to drive over an hour to the only place I could find that did it, and my doctor doesn’t even give it much consideration.
Dr. Gil, can you consider doing a video addressing whether the presence of the "Frank's Sign" crease on the earlobe is a valid physical marker of heart disease?
I am pretty sure that many studies have shown that some statins increase the likelihood of developing diabetes, contrary to what seems to be "suggested" in this video. That of course does not mean that statins overall are not beneficial, but claiming that they should definitely be prescribed for diabetics raises questions in my mind, given the association of taking statins (some of them) and increased risk of developing diabetes.
Thank you very much for this video. I am almost 70 and I had a calcium score done recently, which came back 0. My cardiologist had said that this was a good score but I could still have plaque. I'm actually pretty low risk, I was seeing her because of a heart murmur. But thanks to your video I understand much better what she was saying, and I also find it reassuring to be my age and have a zero score. Really appreciate your information!
My is 1025 and my doctor put me on a statin. I had a stress test and it was fine. I have no exercise restrictions. I’m 70 and work out about every day.
Thanks for the info, but here's my confusion. I have a calcium (coronary) score of 150, but I have zero other issues that typically correlate with coronary disease. I can get my heart rate to 160 with no ill effects. I'm 77, active and not remotely overweight. My diet is good and my bloodwork is exemplary. So what do I do - behaviorally -about the CAC score? My doc pushed statins, I said nope.
the elevated CAC indicates substantial existing plaque. with elevated CAC lipid-lowering treatment is indicated not because statins lower calcium (they can even increase it as covered in this video) but because they lower risk of a cardiovascular event. the goal is not to lower calcium. the calcium is just a signal that plaque is there, and has been there for a while. hope that makes sense
Q. If drfrank's calcium score is 150 but a stress test indicates good heart health...rise in heart rate is sustainable and return to normal is relatively quick...then is it likely or possible that the soft plaque has been significantly reduced or even completely eliminated, and what remains is only the calcified plaque which would not be a problem?
Great video: 100% blockage of my LAD and 90% blockage of RCA, per angiogram. Per all my consultations with surgeons for my bypass, ive had this for years and the extreme calcification, as video points out, saved my life. Because calcified plaque is unlikely to break off. Two weeks ago I had minimally invasive heart surgery to bypass lad blockage and then a stent of the RCA. I'm recuperating now. Had hardly any prewarning signs. My take away: seems only the CTA test can show soft plaque build up (proactive) and CAC test is reactive just to show calcified plaque already built up. Tread mill tests, angina-pain in chest, CAC, cholesterol numbers, etc...wow, the medical industry encourages non proactive methods to see early signs of plaque build up. Very troubling!
My father in law had a CAC two weeks ago on a Monday. That day they scheduled surgery for Friday based on his CAC score. His widowmaker was 85% blocked, they put one stint in and he said he feels the best he's felt in 15 or so years. My mother in law on the other hand had a score of almost zero but is still very unhealthy. Her doc reiterated she still needs to make lifestyle changes even though her CAC score is almost zero.
@@efanjul5768 Sorry should have added that, she is diabetic and severely obese. Good genes I guess? Her heart tests always come back normal though and she eats similar to my father-in-law, yet he isn't diabetic but has heart issues. Her health issues aren't really heart related, they're insulin/diabetes related.
@@colinf2316 That's interesting. One would expect arterial damage from the high blood sugar. It may be not a bad idea to get a CIMT to see if she has any soft plaque, as the Calcium score test doesn't show that. I know women are more prone to decalcification, and maybe that translates into less calcium in their arteries? I don't know, but sure would be interested in the results.
Thanks, Gil, this was very helpful. My brother is 2 years older than me. We both had a calcium study when each was about 57, so his was done about two years before mine. His score was high, something like 580, most of that in the so-called widow-maker coronary artery. Two years later, at the same age, mine was 42, 40 of it in that same artery. I remember being very relieved by this ... as well as surprised. I was then distressed that my cardiologist seemed to be quite concerned by my score and was impressing upon me the importance of continuing statin therapy. "But my score is so low while my brother's was so high." "But yours shows that you are developing plague and you may have soft plaque that is more threatening than measurable hard plaque." I didn't understand but think I do, now. BTW, I've followed his advice on statins in spite of my low score. Hopefully, we caught it early enough and progression will be minimal and, hopefully, what is there will calcify into solid plaque. I've been on an anti-inflammatory med for about 22 years for an autoimmune arthritis. Is it possible that the difference between my brother and me is less inflammation on my part due to 20+ years of this medication? Honestly, when my brother received such a high score, I was afraid to have it done, worried that, surely, 35 years of an inflammatory condition would mean that I was in much worse condition than my brother. Thanks, again, Gil. I always learn a lot from your videos. Alex
hi. interventions lowering inflammatory markers have been shown to lower risk (at least using monoclonal antibodies against IL-6 in people with high inflammation at baseline) so it's possible it plays a role
What an extraordinary presentation & service you provided to those of us laypersons who want to better understand the distinction between obstructive & non obstructive CAD, the role statins play as well as their overall understanding of risk assessment of adverse events over time. Keep up the effort because you should be seeing an increase to hundreds of thousands of subscribers. I’m certainly one. Thank you.
This was nice explanation of possible interpretations of CAC score. I would say that the rational strategy for patients could be if they have high LDL to look first into other markers like Trigs, HDL and CRP. If those are really good then ask doctor for Apo B test. If Apo B is not high, you are very likely fine, else you have a problem. If Apo B for some reason can not be done, ask for CaC test. If that is not zero, you might have a problem. In all case when you might have a problem you should try to change your diet and lifestyle first. For me it was enough to switch from butter to olive oil and coconut oil and my LDL dropped 50%. So fortunately I did not have to take statins even though that was the first thing my doctor wanted to put me on without even suggesting any other tests like Apo B or CaC score. Statins should be the solution of the last resort. I do not know how expensive Apo B test is, but I doubt that more than all the statin people have to take for many years. So it is not clear to me why doctors do not want to order those tests or insurances do not want to pay for them.
Apo B is about 25 bucks. It is the single most important metric. Trig to HDL is good, but none as definitive as APO B to identify ldl particle count risk. NMR will provide a ton of info on particle counts and size, as well but more expensive.
I think it would have been helpful to just SUMMARIZE the CAC as a risk factor stuff, and then go on to explain what ApoB is, explain Agatston scoring, talk about Vitamin K2, etc. What you have here is quite helpful, but leads to other questions and related issues.
k2 is good but not when on certain medications blood thinners. I have a low calcium condition and limit bad processed foods like anything in a tin even tinned soups, tinned fruit have syrup, Sugar, Artificial Sweeteners, Baked Products, Tea, Coffee, Fizzy Carbonated Drinks even Sparkling Water, Tonic Water, Spinach bad high Calcium, Kale Protein Powders, Cakes, Pastry, Pasta, Sweeet Potatoe. Calcium pulls Calcium from Bones. mines not absorbed.
Calcium score is not the whole picture. 10 years ago I had one done as part of a complete physical exam. My score was 721. I was referred to a cardiologist who conducted a heart cath a few days later. There was a 40-50 stenosis in the diagonal branch with minimal luminary in the other vessels. I was already on 20mg atorvastatin but was increased to 80mg along with daily small aspirin. The statins stabilize the plaque and I can still run 10 miles with no problems. There could be non hardened matter in your arteries that will not show up as calcium. I was on 20mg statins for 10 years before the scan which means that it stabilized the plaque and it showed up but not serious blockage. Bottom line, my cardiologist said the very worst would be to place a stent in that diagonal branch in the future if anything. So, the number in and of itself in not the complete story.
i dont know anything about this so i like that im learning high quality information for my first understanding of the topic of calcium scores Thanks Gil
Dr Gil ,I had a CTA Angiogram and it showed a calcium score of 127. BTW I am a 61 y/o male with no medical hx. The test also showed that I had focal calcification of the LAD(left anterior descending coronary artery) with an estimated stenosis of less than 15%. My cardiologist didn't seem too alarmed by those results. He said less than 15% is fine for my age group. Reason for the test was that my ApoB came back at 150 and LDL 193. Did a follow up nuclear stress test and passed it with above average for my age. Now i am on 10mg crestor with a change in diet.
hi, yes these values are very high, seeking the care of a specialist is 100% the right move. lifestyle changes + meds in this case absolutely indicated due to both the lipid levels and the CAC. other family members may also benefit from screening since at those values we start to think of genetic determinants
So to your points 3 and 5, I'm 78 my CAC is 1054, yes! but all other factors (wt, vo2 max, bp, etc), good or great. Radiologist told me the calcium is on outer layer of thearteries, not the interna so it's stable, basically no problem, so no statin. Thoughts? Great videos, thanks!
Excellent! Loved the idea od 30 year view of risk. BTW, angiography is better than calcium scorebut still an image of the lumen, not the arterial wall. Many open arteries have soft , vulnerable plaque burden only visible via intravascular ultrasound.
Coronary artery calcification is a continuos process and does occur in the early stages of plaque formation although it may not be detected on CT scan with a threshold below 130 HU used in the Agatston protocol.
This is an excellent video Dr Carvalho! My cholesterol levels though in green (all total, LDL, HDL, trigylcerides) I still went ahead and got my CAC done. I am not over 40 yet. But I don't want to a CT Angiogram given the risks of radiation (price is secondary). But without CTA as I understand we can not mark ourselves lower on the risk levels. The only thing additional I thing I can do to get a truer sense of my cardiovascular risk is to get an apoB test perhaps. If you could do a video as to the different tests and holistic analysis a person can do to get a true risk score for their heart it would be great. Thanks for all your videos doc!
Quest does Advanced Lipid Panel, Cardio IQ test that all cardiologists order (but your PCP could order, too) and that will also report you Apo B and Lp(a) levels. Good luck!
Your videos are well-organized, indexed, brief, and explained with clarity, which is all the opposite of Dr. Ford Brewer's videos. In a just world, you would have the gazillion views instead of him.
CIMT Test( cardiac intimate medial thickness) was not discussed here. Do you have a podcast discussing that ? I would be very interested in what opinions and assessment Thomas Dayspring MD as of CIMT Test.
Retired physician here. About 15 years ago I had depressed ST in my inferior leads on a stress test. The nuclear scan showed decreased perfusion at the apex. Based on that, I underwent a heart cath. It showed my LAD sort of dwindled down in the distal artery. There was nothing to stent. Since I had no symptoms nothing was done. About 5 years ago I saw the same cardiologist because I wasn't happy with my BP management. He talked me into a repeat stress test and nuclear scan. The ST depression was not present. The nuclear scan was negative. He ordered a CAC, but Medicare didn't cover it. I deferred the test and did some research. To summarize, it looked like no matter what the CAC was the recommendation was to counsel diet and exercise. In over 4 decades of practicing medicine I had a rule about ordering tests: I'd ask myself "What will I do if it's positive and what will I do if it's negative?". If the answers were the same I didn't order the test. I never did the CAC and remain blissfully ignorant at the age of 70. I think I have the best prognostic test of all. My parents lived to be 92.
One more thing. Statistics apply to groups of people, not individuals. If studies show that 75% of patients respond favorably to treatment, that doesn't mean you have a 75% probability of successful treatment. What it means is that if you treated 100 people, there would be roughly 75 successes. However you cannot determine which specific individuals would respond. You can only estimate how many would respond. This is why you can't get rich flipping coins. You know the odds are 50-50 but you have no way to predict the results of the next toss.
Thanks for sharing your experience. I'm going through something similar. I had an angiogram which revealed dwindled LAD. Like you, nothing was done. The cardiologist wants to put me on aggressive statins, beta blockers, and aspirin. I'm 67, swim 10,000 meters per week (mostly intervals), lift weights, and play tennis. Never had any symptoms and blood pressure is good. What is your opinion of statins, etc.
I'm 70 and took the CAC and it was 264. I'm Glas I did cause it made me change the way I look at carbs and sugars which I keep low now and also lowered my saturated fat intake plus added some supplements like niacin and high K2. Doc wanted me on 20mg Crestor but I am trying 5mg to see how my blood work looks later.
Very interesting. As I understand you failed one exercise stress test but passed another, five years later. What did you conclude about the cause of the first test result?
Agreed, the two together are very useful. Luckily I have zero CAC and 'no significant stenosis' on CT. They did find a mildly enlarged left atrium but said not to worry. I'm still working through that!
A great video. At 64 my score was zero. It made me feel good, but now I am so much more informed as to what this means now and in the future. Thank you so much for this info!
I'm 65 (male) and have been told for years my cholesterol is high (total 250), but LDL that is around 150, HDL is 85, and VLDL at 10 or or (i.e., triglycerides at 45 or so). My doctor keeps s saying I needed a statin and suggested a CAC that came in at 0. She still suggests a statin but particularly at my age, I see no reason (BMI is 24, waist is 36 inches, hs-crp is 0.6 and has been so for years, no BP issues). My 10-year risk on the MESA calculator without considering the 0 CAC is 5 percent and 2 percent with the 0 CAC. ACC calculator has me at 10 percent risk with advice to take a statin to get risk to 9 percent. Even if I thought I needed a statin (I don't), the difference in risk per ACC seems pretty small - Does make me wonder if ACC overestimates risk. Thoughts? Including whether I should take statins??
Yes it can see inside the vessel, if the plaque becomes calcified. It’s like bone on an X-ray. It can’t see soft plaque in the vessel that’s true. In my opinion soft plaque is much more dangerous than calcified plaque.
Can we have some episodes for exercise, weight lifting, HIIT,cardio...for optimal health, what's best exercise type for what situation and similar... ?
Thank you so much for what you are doing! I’ve been binge watching your videos for the last couple of weeks, and I have learned a ton. I will be forever grateful as I journey down the path to better health. OK for my question! I keep hearing Apo B over and over. Six months ago my apo b number was 101 and now I have gotten it down to 79 with diet. However, I don’t really understand what number I should be aiming for. Is there an optimal number? I also brought my LDL down from 126 to 101. Yay! I’ve been doing the Mediterranean diet. Thanks again!!
So much time spent on zero CAC I just learned I have 612 at 72 years old 5'9" and 155 lbs never smoke or drank or drugs - but cheese chocolate and ice cream
I'm 56 and about 3 years ago, (just before COVID hit) I was told my calcium score is in the top 70% for people my age. My doctor soon retired from practice and since then, I haven't seen a doctor. I'm now trying to get a new doctor and the first one that has a slot for me is more than a month away. In the past 3 years, I've improved my diet drastically and while not completely vegan, I eat lots of vegetables and prefer salmon for my meat. (No more hamburgers or BBQs). My question is this. To prepare for my doctor's appointment, I would like to go to LabCore and get some blood tests done (at my own expense if needed). Which blood work should I do? Is it possible with a high calcium score that my drastically better diet would have improved my calcium score? Am I a candidate for a statin and if so, is that something that is only temporary, or are people typically on them long term. More information, for those that made it this far. I'm very athletic and healthy otherwise. My resting heart rate is in the low 40s and I swim for an hour 3 times per week and weigh about 180 lbs for a height of 6 feet, so not ripped, but not overweight either. Any comments on that calcium score? If I do an ApoB blood test what should I look for?
I had my CAC taken 3 years ago when I was 56 years old and I had a score of 390 while my LDL was 145 so this worried me. My cardiologist put me on statins and 3 months later I got a CT angiogram taken. On that 3 of my coronary arteries where blocked 35% and the plaques where already hardened which was good news against rapturing. So now I take my statins and every year go for Echo Stress cardiogram in order to understand if there are any issues. So actually knowing your situation helps you better manage your risks
What I love about Drs like Dr Dayspring and Gil, is that they ultimately dont have a dog in this fight. You can tell how much they just care about the facts. If something were to change in our understanding of heart disease tomorrow, I can easily see Dr. Dayspring changing his mind to match the evidence.
Exactly!! Contrast with cholesterol deniers like Paul Saladino who makes a fortune selling his animal organ supplements. Or more generally anyone who has made arguing for low carb, pro saturated fat etc a core part of their brand
Thanks Gil.! My girlfriend and I watch all your videos. We really appreciate your unbiased, scientific, and thorough research. As "Cutabove" commented below, why not get a cimt test? It is has no radiation and also shows soft plaque. How does a cimt test compare to the CAC test? Thank you!
I also have very high CACS: 1126 (95th %-tile for 64-yo), which probably occured during my NASH cirrhosis and hepato renal syndrome prior to my liver transplant, 6 years ago. But I have since gotten in really good shape, and I find there is no stenosis (per heart Dr. stress test). My conclusion is that vascular smooth muscle cells are not terminally differentiated, and can morph their phenotype to become osteoblast-like, and that my calcification is not (mostly) from plaque but from medial, ie arterial VSMC calcifications. What d'yall think about that?
Great video and clear explanations, especially of the myths interpreting zero CAC scores. What about the combination of these factors: a) age 60 -70, b) CAC score above 100 (moderate risk category), and c) history of statin use? Given that statin use may have contributed to elevating the score, how would you evaluate the risk associated with a score above 100 for this age and history of statin use? (Asking for a friend) :)
Would be great if you discussed alternate day statin regimen or even once or twice weekly statin regimen. I found just taking 5 mg on Mondays and Thursdays lowered my LDL far below 100 and obviously some people respond more strongly than others but nobody is going to get side effects if they are taking it once or twice a week.
Dr. Brewer takes Crestor only 3X weekly. and meets desired results.Meeting w Cardio soon as calcium score 3 262 in LAD and 264 in RCA severe muscle pain ongoing 5+ months after stopping Simvistatin, tried a few others. Can't take ASA due to CKD. Leary of PCSK9 and sRNA cholesterol meds. We will have a talk. I'm sure he will want an angiogram, which I'm open to if pre--labs say kidneys are up to the dye. Good blog.
Having worked in a cath lab for 11 years, we had so many positive CTA that turned out totally wrong. Same with stress tests. If you truly are worried get a cardiac cath which is the gold standard and if they find anything they can fix it. Note they don't stent anything under a 70% blockage, unless the FFR shows very poor flow across the lesion.
@@travelnomad2128 Yes, I would think , that in the absence of symptoms or other hard evidence, doctors are not going straight to a catheterization with its attendant risks and cost issues. But I do not dispute the point made that CTAs and CAC scores may be unreliable.
Hi, love your channel recently found it. I'm 57 and after a chest ultrasound got a result of calcification so I got further check up . Found out my cac score was 34. Got a nuclear med stress test done also. Cardiologist said my calcium is on the outside and my arteries are clear with good flow and a strong heart. I asked I'd I had any blockage. His response was minimal if any and said around my age everyone has some but he's not worried about me. He did recommend a statin but said it was my choice. I have 2 questions. First is what dies the calcium on the outside of the arteries mean how does it get there and is it dangerous being outside as opposed to the inside. I haven't been able to find anything searching internet about calcification outside the arteries. 2nd question I haven't had my cholesterol and triglycerides checked because I'm a difficult draw (usually an ultrasound needed to get my veins) they've missed last 3 times. Should I take a statin if my cholesterol levels are fine as a preventative measure? I don't like taking meds unless it's necessary. Thanks for the help and I really enjoy your videos. Honest and very thorough with a lot of good research 👌 👏 👍
Yes most know about the side effects but it's also about risk vs reward. I may not need one but it may save some people's lives. Better to deal with some side effects then to be dead if you are one of the ones at high risk. I don't think I'll be taking one now since my cholesterol was decent but I'm sure some people actually need them.
@@realtraveler2919 you're not appreciating how bad some of the side effects can be. I know a number of folks who have permanent issues. Not trying to scare anyone, but a deeper exploration into side effects is warranted
Coroners saw plaques regress in occupied Denmark during WWII. The Germans forced the civilian population to send all their meats and dairy to the front lines. The whole country was forced into mild caloric restriction and veganism. The coroners kept on doing autopsies on people that died unexpectedly and they wrote of seeing these shadows on the inside of their arteries where it was obvious plaques had been. Their rates of heart attacks and strokes reduced fairly dramatically almost overnight and as soon as they shipped off all the meat and cheese to the front lines. It is one of the few examples of a population being forced off animal products and could not be replicated easily today. The data of reduction of death by heart attack and stroke seems pretty unequivocal. Correlation vs causation is always tough, but It shows what it shows.
😮😮😮😮I'm a 57 year old female, pre-diabetic and 100 pounds overweight. My calcium score is zero. A friend of mine is in his 70s. He was at a normal weight and had normal cholesterol. No symptoms of heart disease. He decided to get a cardiac calcium test. His score was 1500!!! Upon further more evasive testing it was discovered that he needed a triple bypass!!!!
65 yr old female. Thin. Very physically active. Watch my diet closely. Cant take statins. Take Praluent injection and zetia. . Calcium score of 700. Failed a stress PET scan. Headed to cath lab. Cath showed no sign of blockage. 20% narrowing in one place. Said that was normal for my age. Any thoughts?!
Defining obstructive CAD as 50% is an ancient definition. Obstructive CAD causing symptoms typically require a stenosis of at least, again at least 70%.
Pricing of CTA as mentioned @ 11minute mark. Dr. Dayspring says the CT Angiogram test is 10x priced higher than the CAC test. In my area, Jax, Fl., the CAC test is $99, while the CTA scan w/ CAC score is $350. I checked with my insurance company and found that the CTA test would cost $380 as a deductible.
I got mine score last week, 437. I will be 66 in March and eat very healthy. My doctor said it's herdity bc im not overweight and never smoked or drank, but occasionally, a drink she is setting me up with a cardiologist. I'm very nervous about it. My mom and dad both had heart problems. I do have high cholesterol, but I couldn't take statins made my whole body ache. They did ultra sound on neck arteries that test came by good .
A helpful video indeed. The current problem is that cardiologists (and most doctors) do n ot take the time to educated the patient as thoroughly as this video. My calcium score is zero at 75 years old, but the cardiologist has prescribed a statin due to high cholesterol. I'm told I need the statin if I want to live to be 90 years old. So, now I have urination side effects. Maybe my body likes high cholesterol? Or maybe Zetia is a better alternative? So many questions with so few answers.
Dr. Dayspring--Great information. Last year after a friend had a heart attack I asked my Doctor what test might show if I was at risk. I asked him for a CRC test. Went and the results were 2200. My doctor said it was the second highest in his history He ordered a Nuclear stress test which I completed and it revealed no blockages. My doctor only recommended diet and exercise. I researched anything that could help -- I added Vitamin K2 and Berburine. My doctor has no further recommendations but to get further scans every 3 months. Recently I researched Nattokinase which has proven to reduce plaque. I sent the information to my Doctor waiting on response. Should I see a specialist?
Calcium score doesn't make sense to me. vigorous exercise among middle age to elderly increases coronary calcium as do statins. I read that coronary calcium is less important when exercising because exercise helps prevent heart attacks and statins are good because the calcification helps to prevent the plaque from rupturing. I also read that coronary calcium score doesn't mean there is lipid or cholesterol build up since you cannot see the beyond the calcium. Either calcium in the coronary arteries is good or bad--how could it be that sometimes its OK and other times its bad? Furthermore, I have read studies that say that vitamin K2 decreases coronary calcium. Is that correct?
My diet has been near perfect (low carb, only healthy fats, lots of salmon, sardines and grass-fed beef and eggs) for the past few year and I'm metabolically healthy, yet my CAC score went up from 26 (age 49) to 118 (age 52) over the past two years. I have no idea what to do with all the conflicting information.
I had a CCA done but didn’t get a total score. I had 3 areas that were positive. They were measured in percentages, like 1-20%. So do I add the three numbers up to come up with a total. Would my total be 3-60?
I had a score of 0 on the cac but the report stated "punctate calcium noted in aorta" as a sidenote. I wonder why they didn't make an issue out of this. It doesn't sound great to me unless I'm missing something?
My story is a bit different. 10 years ago at age 55 I had a routine cardiac calcium score test result of 721. I was referred to a cardiologist who did a heart cath two days later. The result was 40-50% stenosis at the diagonal branch with minimal luminary stenosis in all the other vessels. I was already taking 20 mg of atorvastatin and 81mg aspirin for the previous 9 years but the statin was increased to the 80mg max dose after the calcium score/heart cath. No side effects from the statins. Since then, yearly cardiologist appts, two nuclear stress tests and I can still run 6 miles like greased lightning. Obviously the calcium plaque was not in my arteries. I am told worst case scenario would be a stent if it gets worse. I’m told that statins stabilize the plaque and actually causes it to ‘regress’ a bit. So, a high calcium score is not all that it’s cracked up to be but it needs to be followed up on. My $.02
It really sucks that it can be so hard to get a CAC or Apo-B test... If you have lousy insurance, getting more than a basic (and of limited use) cholesterol test is difficult or impossible, unless you offer to pay out of pocket.
My CAC was $125 out of pocket in April. I finally convinced my Physician's Assistant to give me a script for the CAC and an advanced lipid panel I requested. She was very hesitant and seemed annoyed that I asked multiple times.
What about taking vitamin K2 / MK7 and D3 while taking a statin? For example if someone had a moderate risk CAC of 200. I would like to hear your thoughts on that.....really appreciate the data-based approach in your videos.
So appreciate the solid and up-to-date scientific information you share here. If anyone knows of lipidologists or cardiologists in NYC who are also up-to-date on ApoB/LP(a) as key risk markers to address, and whose practices are informed accordingly, can you share their names with me? Most I have found so far are patronizing about it and are not convinced it is important. It is hard as an active and informed patient to find doctors who are too!
Curious if you ever found any? IM on Long Island, Dr wants to put me on statin for 330 CT score but LDL was only 95. So far Im resisting. Thanks for any info.
I’m 46 and a year ago found out I have a CAC of 146. Big surprise. I have used this information to radically change my diet and lifestyle. Two cardiologists have refused to refer me to get tested to look for soft plaques. I don’t want to take statins but I understand it is likely a must. My cardiologist agrees with my plan to take a low dose statin every other day to start.
I found your video very informative, but there is some information that the other doctor said about not being able to get a CTA readily I’m on Medicare advantage and I had one done four years ago at Cedar Sinai in Los Angeles. I did that one just before I went onto Medicare actually, and I paid for that one myself but I’ve had two subsequent ones because of familial issues and I never had any issues getting it paid for by Medicare whatsoever and of course it’s a very good scan when you have the dye done as well, but I just wanted to make that note I don’t think it’s that difficult to go ahead and get one done and get it paid for it to be honest with you
Another telling example is calcium score among athletes that is higher than average but obviously athletes are not at higher risk of heart attack. They tend to have fewer soft plaques despite higher CAC.
I wouldn't be so sure with that statement: "obviously athletes are not at higher risk ". Comparing people who exercise with potato couches is not the way . Extended exercise and lifelong overtraining doesn't lead to longevity.Many Athletes by themselves know that.
@@georgeborb2848 splitting hair, I'm talking about normal recreational athletes that are the vast majority. I'm aware that long term very intensive activity may cause some increase in heart blocks and atrial fibrillation, but to my knowledge there is no demonstrated increase in cardiovascular events or mortality linked to atherosclerosis. That's what we are talking about here.
I went in for an angiogram, and my cardiologist found all kinds of calcified blockages, he said it was from dialysis, and i think warfarin contributed to it too, im 33. Going in to have 2 more stents placed soon
Can you post a link to the studies that demonstrate that statins increase coronary calcium and thus CAC? I have heard several online cardiologists mention this but my cardiologist wants the studies. Evidently, he is not aware of this phenomena or does not believe it. Thank you
Had read if gene is 9p21 that statins can make worse , is there info on what may behelpful (also Lpa ). Appreciate this information on Ca score and age. Would a INTIMA (neck artery ultrasound) be useful and you mentioned legs can have clogging ?
I had CAC score of 0 thru my 50’s. Went up to 150 by early 70’s. Passed a nuclear stress test and got an all clear. Then suffered major MI while on treadmills at the gym. Always in good cardio/ resistance training shape. I had a ruptured plaque in a major cardiac artery. Being a retired firefighter/paramedic I got my ass into the ER within 10 minutes. Only thing that saved my life
Would you please share how the ER docs treated you. Was it just rest, medical pharma care, stents, or bypass surgery? Thanks much.
Good for you. I think so many people have them and think they will just sit it out or "it will pass" and don't get themselves to the ER. I hope this inspires you: my mother had emergency bypass surgery in her 70's, and a valve replacement at age 93. She just turned 100! She was fishing, driving, gardening, etc. well into her 90's, and lived alone until 97. The only time she goes to the dr. is once a year to the cardiologist and opthamologist.
I'm glad you're good, brother. Stay safe
@@jeannepeters88362 emergency stents with removal of the clot. The ER staff was amazing! They recognized the probable MI and had me up in the catch lab really quick. They saved my life for sure. The nuclear stress test 2 weeks earlier didn’t detect any problems??😮. Go figure!
How did you know it was a MI? What did it feel like?
Family history of heart disease. Calcium score and my father (5 stents) asking me to get checked out led to a calcium score test recommendation from my primary care (Dr. Adam is awesome btw) and it likely saved my life. I had no symptoms and had the truck packed for a camping trip. CACS score was 1,441 (! Yes out of 0-400), stress test mild blockage, heart cath showed 3 blockages (100/80/50), and now I am in cardiac rehab from a triple bypass and I’m doing well thanks to the love and support of so many people. Several colleagues have gone for calcium tests and all have come back good - God bless. Please do this test if you have a family history, high cholesterol, high blood pressure, or any concerns about your heart health - I had no symptoms (age 53).
I am glad you are doing great. But this videos is saying that the CAC test doesn't' tell us enough so I am confused. Thank you.
@EEEBA1 zero score doesn't mean you are safe, but that you are more likely to be safe. High score means you definitely have a problem. Although, you'd find out just as easily from a stress ECG. (I did, and only with 40% blockage.)
@gineering I had a Calcium score of 1400 a few months ago ordered by my primary. I had a CTA done last week of my heart and a ultra sound done a week earlier. I have no coronary blockages. Echo Cardiogram showed no issues with blood flow either or the structure or mechanics of my heart. I was shocked. I dont think my cardiologist was shocked but I think he was not expecting those results. He said my calcium is there but distributed through my heart and he talked about other things etc concerning calcium. Im 59 years old.
@@vincec2112 have you managed to reduce your Calcium score or what?
@@sascha6176 Hi, I have not had a calc score done since that first time several months ago. I am seeing my cardiologist in about 3 months. I will bring this up. I have a feeling he will say there is no need for another one. But I have lost about 30lbs since that calc score and i am eating better and exercising. It would be interesting to see what it is at this point.
I’m 71 and about five years ago had a CAC of 1700. My cardiologist upped my statin dose from 10 mg to 40 mg, and I remained on a baby aspirin a day. A few months later I also had a CTA. As of today, I have remained on the same medication and I am and have always been asymptomatic. One variable that I think came into consideration is that I’m also an avid runner and have been for some 40 years.
There have been studies that show plaque being stable in runners. In addition, an extensive Cleveland Clinic study has shown that statin and aspirin have been just as effective as stents at preventing serious coronary outcomes in asymptomatic people. So far, so good, my cardiologist has more than once said that my plaque is stable. I’m certainly hoping it stays that way! Thanks for the great video!
I doubt if many docs explain this as thoroughly to their patients as you guys have done.
Saying that CAC is not accurate is enough you don’t need a whole lecture and a lot of technical details while patients are waiting
I haven't found a Dr that explains a thing.lol. TH-cam Drs explain things way better than any of the multiple Drs I've ever seen.
We pay the doctors, but they can’t explain it like this. I am on my third doctor only because I’m looking for a doctor to explain to me like what I just heard on this video.
61 YO. Had a test done at 58. Score - zero. Had the test done on a road trip 500 miles from home. Was on a bicycle vacation. The techs weren't supposed to say anything but they were chuckling and told me nothing to worry about. Got the official results a few weeks later. Best $100 I've spent for peace of mind. Probably do it again one of these days.
Did you watch the video? Zero score does not equate to peace of mind.
What is your diet like?
@venicebeachsurfer I train for bicycle races, so burn a good bit of calories, pretty carb heavy. Rice, fruit, lots of eggs, couple of slices of bread daily, peanut butter. No alcohol or coffee.
My health has greatly improved since switching to less (unhealthy) carbs, more ( healthy ) fats and (least toxic) fruits , but this video is a home run that we all needed when it comes to knowledge of cardiovascular health. Bottom line is, health is all about balancing your diet that is based on organic and least toxic whole foods and exercise. Like they say, " you don't stop moving when you get old, you get old because you stop moving".
Paul saladino diet? Be careful it gave me a stroke
I feel much better after watching this video. I am a 65 year old male and have been on a statin for 20 years. I had a CT scan last week and my score is 1350. I am headed to the cardiologist in July. I would prefer a lower score of course, but it is good to know that this could be a good thing in my case. Hard stable plaque. Thanks.
High calcium low magnesium and vit b1.. or acv…just do your research…there’s chronic deficiency of other nutrients to balance body function…change diet
I've always had good cholesterol levels and I'm now 68. My intake of sodium was above normal but doctors always said that since I didn't have high blood pressure it was fine. Last year my doctor came out of the blue and recommended a CAC just to see where I was at. The score came back over 500 and I immediately went on a statin. Now that I've done some research, sodium also appears to be a big factor with getting calcification. I now feel that all those years that I was being told not to worry, I should have been taking steps to reduce my sodium intake. Now I feel like I'm in a could-a, would -a should-a situation. I had a treadmill stress test and blood flow was good. Now I'm really confused. How can I have a high CAC but with good cholesterol levels and blood pressure?
@@SET12DSPWonderful! How are you remodeling your plaque?
@@thomasryan5681 I highly recommend reading, Dr. Caldwell Esselstyn’s book, prevent and reverse heart disease. Also all the TH-cam videos that he speaks on.
I recommend looking into a whole food plant based diet with no added sugar, oil, or salt.
Read Dr Esselstyn’s book .. Prevent and Reverse Heart Disease.
Thanks Gil - for a wonderful explanation. I have a friend who is on a keto diet (long term) , heavy smoker but also exercises regularly - at 57 years - has a CAC of 0. On the other hand, I , also 57, a vegetarian, with normal TRGs and lipid profile, but overweight and don't exercise regularly, have a CAC of 10. I guess, both of us have to make lifestyle changes and not rely exclusively on the CAC. Thank you very much - I really like your channel and explanations.
I am a neurosurgeon and deal a lot with brain haemorrhages and similar conditions - the most common underlying theme I find amongst affected patients is a combination of obesity, diabetes, hypertension and lack of exercise....and, increasingly encountering patients in their early 40s with brain strokes...
There was a recent study showing a big link between diabetes and heart disease. People with diabetes are 2 to 4 times more likely to die from heart disease.
But is your Keto friend normal or raised LDL? Alas I am 40% which on Keto has doubled LDL, so need to stop Keto
I lost weight on Keto but it really shot my Triglycerides up I usually run in the normal range and even have over cholesterol around 180. LDL always been 75% of it which isn't good. That Keto diet sent my triglycerides from 120-130 to over 300 so I cut high saturated fats from daily to every few weeks at most.
Coloestetol numbers mean nothing by themselves. Also, arteries must already be damaged for plaque to accumulate. So a high ldl is not a lone indicator of issues.
I had a score of 1188, mostly in the widowmaker artery, and was sure I was going to die any minute. That was 11 years ago and so far I’m still alive and no “events” but the day’s not over yet.
Did you ever find out how much blockage you had? Did you go on a statin, or have a stent put in?
@@patrickbercini2718 They put me on a statin. and a blood pressure med. Many years later I had a doppler ultrasound test which they said was normal. For what it’s worth, I take two kinds of vitamin k2, one from natto and one from animal sources, and ride my bike most days.
@@gabymalembe Get a CT angiogram.
Wow.. so you may have a protective HDL factor..
@@gabymalembedo you still use a statin?
This is the best explanation of calcium score I’ve ever heard. Thank you so much for your service to humanity. Keep up the good work:)
How this man doesn't have millions of subscribers is beyond me...
I agree
People would rather listen to quack chiropractors.
Because it’s easier to believe doctors that tell you there’s nothing to worry about.
He's not a quack and is unbias.
Can t say enough about your excellent content, well-explained with important guests and giving the most important information to viewers. I really admire your work and the person you are. All the best Gil...
I believe what most people would be interested in is a inexpensive and reliable way of judging and following their heart health over time. The only way I see of doing this is with a CIMT test repeated every few years. It's cheap, no radiation, isn't intrusive and available everywhere. How about a video discussing how people can track their heart health using inexpensive tests? And in particular the benefit of the CIMT over other tests.
CIMT is available everywhere? I had to drive over an hour to the only place I could find that did it, and my doctor doesn’t even give it much consideration.
Cardiac cath test is best. CIMT just checks the neck.
Dr. Gil, can you consider doing a video addressing whether the presence of the "Frank's Sign" crease on the earlobe is a valid physical marker of heart disease?
I am pretty sure that many studies have shown that some statins increase the likelihood of developing diabetes, contrary to what seems to be "suggested" in this video. That of course does not mean that statins overall are not beneficial, but claiming that they should definitely be prescribed for diabetics raises questions in my mind, given the association of taking statins (some of them) and increased risk of developing diabetes.
hi, we covered that in detail here: th-cam.com/video/1HDfzA7eIqQ/w-d-xo.html
Thank you very much for this video. I am almost 70 and I had a calcium score done recently, which came back 0. My cardiologist had said that this was a good score but I could still have plaque. I'm actually pretty low risk, I was seeing her because of a heart murmur. But thanks to your video I understand much better what she was saying, and I also find it reassuring to be my age and have a zero score. Really appreciate your information!
congrats!!
My is 1025 and my doctor put me on a statin. I had a stress test and it was fine. I have no exercise restrictions. I’m 70 and work out about every day.
Thanks for the info, but here's my confusion. I have a calcium (coronary) score of 150, but I have zero other issues that typically correlate with coronary disease. I can get my heart rate to 160 with no ill effects. I'm 77, active and not remotely overweight. My diet is good and my bloodwork is exemplary. So what do I do - behaviorally -about the CAC score? My doc pushed statins, I said nope.
the elevated CAC indicates substantial existing plaque. with elevated CAC lipid-lowering treatment is indicated not because statins lower calcium (they can even increase it as covered in this video) but because they lower risk of a cardiovascular event. the goal is not to lower calcium. the calcium is just a signal that plaque is there, and has been there for a while. hope that makes sense
Q. If drfrank's calcium score is 150 but a stress test indicates good heart health...rise in heart rate is sustainable and return to normal is relatively quick...then is it likely or possible that the soft plaque has been significantly reduced or even completely eliminated, and what remains is only the calcified plaque which would not be a problem?
Great video! Is there a way to reduce your calcium (score) if it is already higher than your age group? K2?
why would you want to take out stablised plaque - the calcium isn't the problem, its the sticky plaque.
Great video: 100% blockage of my LAD and 90% blockage of RCA, per angiogram. Per all my consultations with surgeons for my bypass, ive had this for years and the extreme calcification, as video points out, saved my life. Because calcified plaque is unlikely to break off. Two weeks ago I had minimally invasive heart surgery to bypass lad blockage and then a stent of the RCA. I'm recuperating now. Had hardly any prewarning signs. My take away: seems only the CTA test can show soft plaque build up (proactive) and CAC test is reactive just to show calcified plaque already built up. Tread mill tests, angina-pain in chest, CAC, cholesterol numbers, etc...wow, the medical industry encourages non proactive methods to see early signs of plaque build up. Very troubling!
My father in law had a CAC two weeks ago on a Monday. That day they scheduled surgery for Friday based on his CAC score. His widowmaker was 85% blocked, they put one stint in and he said he feels the best he's felt in 15 or so years. My mother in law on the other hand had a score of almost zero but is still very unhealthy. Her doc reiterated she still needs to make lifestyle changes even though her CAC score is almost zero.
How can a score of almost zero be unhealthy? Her doctor should be telling her to keep doing whatever she's doing, IMO.
@@efanjul5768 Sorry should have added that, she is diabetic and severely obese. Good genes I guess? Her heart tests always come back normal though and she eats similar to my father-in-law, yet he isn't diabetic but has heart issues. Her health issues aren't really heart related, they're insulin/diabetes related.
@@colinf2316 That's interesting. One would expect arterial damage from the high blood sugar. It may be not a bad idea to get a CIMT to see if she has any soft plaque, as the Calcium score test doesn't show that. I know women are more prone to decalcification, and maybe that translates into less calcium in their arteries? I don't know, but sure would be interested in the results.
The advice of life style change is 👍
@@efanjul5768 Its the soft plaque CAC is not useful to see that
Thanks, Gil, this was very helpful. My brother is 2 years older than me. We both had a calcium study when each was about 57, so his was done about two years before mine. His score was high, something like 580, most of that in the so-called widow-maker coronary artery.
Two years later, at the same age, mine was 42, 40 of it in that same artery. I remember being very relieved by this ... as well as surprised. I was then distressed that my cardiologist seemed to be quite concerned by my score and was impressing upon me the importance of continuing statin therapy.
"But my score is so low while my brother's was so high."
"But yours shows that you are developing plague and you may have soft plaque that is more threatening than measurable hard plaque."
I didn't understand but think I do, now. BTW, I've followed his advice on statins in spite of my low score. Hopefully, we caught it early enough and progression will be minimal and, hopefully, what is there will calcify into solid plaque.
I've been on an anti-inflammatory med for about 22 years for an autoimmune arthritis. Is it possible that the difference between my brother and me is less inflammation on my part due to 20+ years of this medication? Honestly, when my brother received such a high score, I was afraid to have it done, worried that, surely, 35 years of an inflammatory condition would mean that I was in much worse condition than my brother.
Thanks, again, Gil. I always learn a lot from your videos.
Alex
hi. interventions lowering inflammatory markers have been shown to lower risk (at least using monoclonal antibodies against IL-6 in people with high inflammation at baseline) so it's possible it plays a role
Thanks, Gil.
I thought anti-inflammatories like NSAIDs raise the risk of having heart attack and stroke?
@@okamsug look up the CANTOS trial, I don't remember off the top of my head which anti-inflammatories they used. lmk if you have trouble finding it
oh nm they used a monoclonal antibody against IL-6, I´ll edit my replies above for accuracy. thanks!
What an extraordinary presentation & service you provided to those of us laypersons who want to better understand the distinction between obstructive & non obstructive CAD, the role statins play as well as their overall understanding of risk assessment of adverse events over time. Keep up the effort because you should be seeing an increase to hundreds of thousands of subscribers. I’m certainly one. Thank you.
This was nice explanation of possible interpretations of CAC score. I would say that the rational strategy for patients could be if they have high LDL to look first into other markers like Trigs, HDL and CRP. If those are really good then ask doctor for Apo B test. If Apo B is not high, you are very likely fine, else you have a problem. If Apo B for some reason can not be done, ask for CaC test. If that is not zero, you might have a problem. In all case when you might have a problem you should try to change your diet and lifestyle first. For me it was enough to switch from butter to olive oil and coconut oil and my LDL dropped 50%. So fortunately I did not have to take statins even though that was the first thing my doctor wanted to put me on without even suggesting any other tests like Apo B or CaC score. Statins should be the solution of the last resort. I do not know how expensive Apo B test is, but I doubt that more than all the statin people have to take for many years. So it is not clear to me why doctors do not want to order those tests or insurances do not want to pay for them.
Apo B is about 25 bucks. It is the single most important metric. Trig to HDL is good, but none as definitive as APO B to identify ldl particle count risk. NMR will provide a ton of info on particle counts and size, as well but more expensive.
My Apo A was 177..Wouldn’t a higher Apo A indicate a protective factor? I mean the same as HDL Triglycerides ratio?
How about the Apo B/Apo A ratio?
Great information on value of calcium score ...lots of thanks from Chennai India
I think it would have been helpful to just SUMMARIZE the CAC as a risk factor stuff, and then go on to explain what ApoB is, explain Agatston scoring, talk about Vitamin K2, etc. What you have here is quite helpful, but leads to other questions and related issues.
k2 is good but not when on certain medications blood thinners. I have a low calcium condition and limit bad processed foods like anything in a tin even tinned soups, tinned fruit have syrup, Sugar, Artificial Sweeteners, Baked Products, Tea, Coffee, Fizzy Carbonated Drinks even Sparkling Water, Tonic Water, Spinach bad high Calcium, Kale Protein Powders, Cakes, Pastry, Pasta, Sweeet Potatoe. Calcium pulls Calcium from Bones. mines not absorbed.
Calcium score is not the whole picture. 10 years ago I had one done as part of a complete physical exam. My score was 721. I was referred to a cardiologist who conducted a heart cath a few days later. There was a 40-50 stenosis in the diagonal branch with minimal luminary in the other vessels. I was already on 20mg atorvastatin but was increased to 80mg along with daily small aspirin. The statins stabilize the plaque and I can still run 10 miles with no problems. There could be non hardened matter in your arteries that will not show up as calcium. I was on 20mg statins for 10 years before the scan which means that it stabilized the plaque and it showed up but not serious blockage. Bottom line, my cardiologist said the very worst would be to place a stent in that diagonal branch in the future if anything. So, the number in and of itself in not the complete story.
i dont know anything about this so i like that im learning high quality information for my first understanding of the topic of calcium scores Thanks Gil
Dr Gil ,I had a CTA Angiogram and it showed a calcium score of 127. BTW I am a 61 y/o male with no medical hx. The test also showed that I had focal calcification of the LAD(left anterior descending coronary artery) with an estimated stenosis of less than 15%. My cardiologist didn't seem too alarmed by those results. He said less than 15% is fine for my age group. Reason for the test was that my ApoB came back at 150 and LDL 193. Did a follow up nuclear stress test and passed it with above average for my age. Now i am on 10mg crestor with a change in diet.
hi, yes these values are very high, seeking the care of a specialist is 100% the right move. lifestyle changes + meds in this case absolutely indicated due to both the lipid levels and the CAC.
other family members may also benefit from screening since at those values we start to think of genetic determinants
What about a CIMT test to detect soft plaque?
Thank you for the video. Is calcification is reversible? May be another video?
@@SET12DSPhow?
❤how did you do it?
K2 & D3
Calcified plaque is stable plaque. Stable plaque doesn’t cause heart attacks.
So to your points 3 and 5, I'm 78 my CAC is 1054, yes! but all other factors (wt, vo2 max, bp, etc), good or great. Radiologist told me the calcium is on outer layer of thearteries, not the interna so it's stable, basically no problem, so no statin. Thoughts? Great videos, thanks!
Excellent! Loved the idea od 30 year view of risk.
BTW, angiography is better than calcium scorebut still an image of the lumen, not the arterial wall. Many open arteries have soft , vulnerable plaque burden only visible via intravascular ultrasound.
Coronary artery calcification is a continuos process and does occur in the early stages of plaque formation although it may not be detected on CT scan with a threshold below 130 HU used in the Agatston protocol.
This is an excellent video Dr Carvalho! My cholesterol levels though in green (all total, LDL, HDL, trigylcerides) I still went ahead and got my CAC done. I am not over 40 yet. But I don't want to a CT Angiogram given the risks of radiation (price is secondary). But without CTA as I understand we can not mark ourselves lower on the risk levels. The only thing additional I thing I can do to get a truer sense of my cardiovascular risk is to get an apoB test perhaps. If you could do a video as to the different tests and holistic analysis a person can do to get a true risk score for their heart it would be great. Thanks for all your videos doc!
Quest does Advanced Lipid Panel,
Cardio IQ test that all cardiologists order (but your PCP could order, too) and that will also report you Apo B and Lp(a) levels. Good luck!
Your videos are well-organized, indexed, brief, and explained with clarity, which is all the opposite of Dr. Ford Brewer's videos. In a just world, you would have the gazillion views instead of him.
CIMT Test( cardiac intimate medial thickness) was not discussed here. Do you have a podcast discussing that ?
I would be very interested in what opinions and assessment Thomas Dayspring MD as of CIMT Test.
Retired physician here. About 15 years ago I had depressed ST in my inferior leads on a stress test. The nuclear scan showed decreased perfusion at the apex.
Based on that, I underwent a heart cath. It showed my LAD sort of dwindled down in the distal artery. There was nothing to stent. Since I had no symptoms nothing was done.
About 5 years ago I saw the same cardiologist because I wasn't happy with my BP management. He talked me into a repeat stress test and nuclear scan. The ST depression was not present. The nuclear scan was negative.
He ordered a CAC, but Medicare didn't cover it. I deferred the test and did some research. To summarize, it looked like no matter what the CAC was the recommendation was to counsel diet and exercise.
In over 4 decades of practicing medicine I had a rule about ordering tests: I'd ask myself "What will I do if it's positive and what will I do if it's negative?".
If the answers were the same I didn't order the test. I never did the CAC and remain blissfully ignorant at the age of 70.
I think I have the best prognostic test of all. My parents lived to be 92.
One more thing. Statistics apply to groups of people, not individuals. If studies show that 75% of patients respond favorably to treatment, that doesn't mean you have a 75% probability of successful treatment.
What it means is that if you treated 100 people, there would be roughly 75 successes. However you cannot determine which specific individuals would respond. You can only estimate how many would respond.
This is why you can't get rich flipping coins. You know the odds are 50-50 but you have no way to predict the results of the next toss.
Thanks for sharing your experience. I'm going through something similar. I had an angiogram which revealed dwindled LAD. Like you, nothing was done. The cardiologist wants to put me on aggressive statins, beta blockers, and aspirin. I'm 67, swim 10,000 meters per week (mostly intervals), lift weights, and play tennis. Never had any symptoms and blood pressure is good. What is your opinion of statins, etc.
I'm 70 and took the CAC and it was 264. I'm Glas I did cause it made me change the way I look at carbs and sugars which I keep low now and also lowered my saturated fat intake plus added some supplements like niacin and high K2. Doc wanted me on 20mg Crestor but I am trying 5mg to see how my blood work looks later.
Very interesting. As I understand you failed one exercise stress test but passed another, five years later. What did you conclude about the cause of the first test result?
CT angiography is the most useful test, even in the setting of a zero Calcium score.
Agreed, the two together are very useful. Luckily I have zero CAC and 'no significant stenosis' on CT. They did find a mildly enlarged left atrium but said not to worry. I'm still working through that!
A great video. At 64 my score was zero. It made me feel good, but now I am so much more informed as to what this means now and in the future. Thank you so much for this info!
If you are a male, zero at your age is very good. If female zero is normal until mid 70s. It can change fast. Check every 2 years.
I'm 65 (male) and have been told for years my cholesterol is high (total 250), but LDL that is around 150, HDL is 85, and VLDL at 10 or or (i.e., triglycerides at 45 or so). My doctor keeps s saying I needed a statin and suggested a CAC that came in at 0. She still suggests a statin but particularly at my age, I see no reason (BMI is 24, waist is 36 inches, hs-crp is 0.6 and has been so for years, no BP issues). My 10-year risk on the MESA calculator without considering the 0 CAC is 5 percent and 2 percent with the 0 CAC. ACC calculator has me at 10 percent risk with advice to take a statin to get risk to 9 percent. Even if I thought I needed a statin (I don't), the difference in risk per ACC seems pretty small - Does make me wonder if ACC overestimates risk. Thoughts? Including whether I should take statins??
I was told by two cardiologists that the CAC test can not see "inside" the artery.
@@stevet5549 :20 I was being polite as I believe Gil misspoke as it does not show inside the artery.
Yes it can see inside the vessel, if the plaque becomes calcified. It’s like bone on an X-ray. It can’t see soft plaque in the vessel that’s true. In my opinion soft plaque is much more dangerous than calcified plaque.
Can we have some episodes for exercise, weight lifting, HIIT,cardio...for optimal health, what's best exercise type for what situation and similar... ?
Thank you so much for what you are doing! I’ve been binge watching your videos for the last couple of weeks, and I have learned a ton. I will be forever grateful as I journey down the path to better health. OK for my question! I keep hearing Apo B over and over. Six months ago my apo b number was 101 and now I have gotten it down to 79 with diet. However, I don’t really understand what number I should be aiming for. Is there an optimal number? I also brought my LDL down from 126 to 101. Yay! I’ve been doing the Mediterranean diet. Thanks again!!
I did too.. My LDL was 127.. They said it’s 99 now..
Can you share your diet? What did you eat to bring it down?
So much time spent on zero CAC I just learned I have 612 at 72 years old 5'9" and 155 lbs never smoke or drank or drugs - but cheese chocolate and ice cream
You must do low carb. Carb is what causes CAC from what I’ve researched.
I'm 56 and about 3 years ago, (just before COVID hit) I was told my calcium score is in the top 70% for people my age. My doctor soon retired from practice and since then, I haven't seen a doctor. I'm now trying to get a new doctor and the first one that has a slot for me is more than a month away. In the past 3 years, I've improved my diet drastically and while not completely vegan, I eat lots of vegetables and prefer salmon for my meat. (No more hamburgers or BBQs).
My question is this. To prepare for my doctor's appointment, I would like to go to LabCore and get some blood tests done (at my own expense if needed). Which blood work should I do? Is it possible with a high calcium score that my drastically better diet would have improved my calcium score? Am I a candidate for a statin and if so, is that something that is only temporary, or are people typically on them long term.
More information, for those that made it this far. I'm very athletic and healthy otherwise. My resting heart rate is in the low 40s and I swim for an hour 3 times per week and weigh about 180 lbs for a height of 6 feet, so not ripped, but not overweight either.
Any comments on that calcium score? If I do an ApoB blood test what should I look for?
Could you explain the other cholesterol tests such as APo B and LP little a? My doctor only does HDL and LDL as well as triglycerides! Thanks
I had my CAC taken 3 years ago when I was 56 years old and I had a score of 390 while my LDL was 145 so this worried me. My cardiologist put me on statins and 3 months later I got a CT angiogram taken. On that 3 of my coronary arteries where blocked 35% and the plaques where already hardened which was good news against rapturing. So now I take my statins and every year go for Echo Stress cardiogram in order to understand if there are any issues. So actually knowing your situation helps you better manage your risks
What I love about Drs like Dr Dayspring and Gil, is that they ultimately dont have a dog in this fight. You can tell how much they just care about the facts. If something were to change in our understanding of heart disease tomorrow, I can easily see Dr. Dayspring changing his mind to match the evidence.
Exactly!! Contrast with cholesterol deniers like Paul Saladino who makes a fortune selling his animal organ supplements. Or more generally anyone who has made arguing for low carb, pro saturated fat etc a core part of their brand
@@FullOfSpuds you need to dig deep , don’t just miss judge Paul salandino, you wish to have healthy markers like he has , lol
this videos are so SOBER!!! thank you!
Hopefully this is not a stupid question.
Do calcium tablets cause a high heart calcium score?
My CAC just cam in @1900 Highest in the country I am 60 feel great but how long do i have with a score like this?
Thanks Gil.! My girlfriend and I watch all your videos. We really appreciate your unbiased, scientific, and thorough research.
As "Cutabove" commented below, why not get a cimt test? It is has no radiation and also shows soft plaque. How does a cimt test compare to the CAC test? Thank you!
I also have very high CACS: 1126 (95th %-tile for 64-yo), which probably occured during my NASH cirrhosis and hepato renal syndrome prior to my liver transplant, 6 years ago. But I have since gotten in really good shape, and I find there is no stenosis (per heart Dr. stress test). My conclusion is that vascular smooth muscle cells are not terminally differentiated, and can morph their phenotype to become osteoblast-like, and that my calcification is not (mostly) from plaque but from medial, ie arterial VSMC calcifications. What d'yall think about that?
Great video and clear explanations, especially of the myths interpreting zero CAC scores. What about the combination of these factors: a) age 60 -70, b) CAC score above 100 (moderate risk category), and c) history of statin use? Given that statin use may have contributed to elevating the score, how would you evaluate the risk associated with a score above 100 for this age and history of statin use? (Asking for a friend) :)
If U R 60-70 & have been using statins, taking CAC test is useless unless somehow you get a CAC score of zero
Over 100 is not good and if me, I would get CT Angiogram, with contrast. Then sort out any disease this detects
I can't believe you don't even take donations you put out such high quality information
Would be great if you discussed alternate day statin regimen or even once or twice weekly statin regimen. I found just taking 5 mg on Mondays and Thursdays lowered my LDL far below 100 and obviously some people respond more strongly than others but nobody is going to get side effects if they are taking it once or twice a week.
Dr. Brewer takes Crestor only 3X weekly. and meets desired results.Meeting w Cardio soon as calcium score 3
262 in LAD and 264 in RCA severe muscle pain ongoing 5+ months after stopping Simvistatin, tried a few others. Can't take ASA due to CKD. Leary of PCSK9 and sRNA cholesterol meds.
We will have a talk. I'm sure he will want an angiogram, which I'm open to if pre--labs say kidneys are up to the dye. Good blog.
This is absolutely the best lucid explanation I have seen on TH-cam!
Any comments on vitamin K2 and calcium buildup.
Having worked in a cath lab for 11 years, we had so many positive CTA that turned out totally wrong. Same with stress tests. If you truly are worried get a cardiac cath which is the gold standard and if they find anything they can fix it. Note they don't stent anything under a 70% blockage, unless the FFR shows very poor flow across the lesion.
Thank you for this information
But how much is cardiac cath? Some ppl are restricted bc of price. So ppl go for affordable tests first.
@@travelnomad2128 coronery Angiograms are only done when you are having an attack.
If you have insurance generally no cost.@@travelnomad2128
@@travelnomad2128 Yes, I would think , that in the absence of symptoms or other hard evidence, doctors are not going straight to a catheterization with its attendant risks and cost issues. But I do not dispute the point made that CTAs and CAC scores may be unreliable.
Hopefully you’ll have a podcast with Dr. Ford Brewer.. great discussion
I absolutely agree!
Hi, love your channel recently found it. I'm 57 and after a chest ultrasound got a result of calcification so I got further check up . Found out my cac score was 34. Got a nuclear med stress test done also. Cardiologist said my calcium is on the outside and my arteries are clear with good flow and a strong heart. I asked I'd I had any blockage. His response was minimal if any and said around my age everyone has some but he's not worried about me. He did recommend a statin but said it was my choice. I have 2 questions. First is what dies the calcium on the outside of the arteries mean how does it get there and is it dangerous being outside as opposed to the inside. I haven't been able to find anything searching internet about calcification outside the arteries. 2nd question I haven't had my cholesterol and triglycerides checked because I'm a difficult draw (usually an ultrasound needed to get my veins) they've missed last 3 times. Should I take a statin if my cholesterol levels are fine as a preventative measure? I don't like taking meds unless it's necessary. Thanks for the help and I really enjoy your videos. Honest and very thorough with a lot of good research 👌 👏 👍
most heart drs will say statin but i wouldn't just eat right stay active and take your supps including fish oil and coq10
The ban was for children and adolescents. Statins are widely used in Europe. Where did you get your information?
Yes most know about the side effects but it's also about risk vs reward. I may not need one but it may save some people's lives. Better to deal with some side effects then to be dead if you are one of the ones at high risk. I don't think I'll be taking one now since my cholesterol was decent but I'm sure some people actually need them.
@@realtraveler2919 you're not appreciating how bad some of the side effects can be. I know a number of folks who have permanent issues. Not trying to scare anyone, but a deeper exploration into side effects is warranted
Coroners saw plaques regress in occupied Denmark during WWII. The Germans forced the civilian population to send all their meats and dairy to the front lines. The whole country was forced into mild caloric restriction and veganism. The coroners kept on doing autopsies on people that died unexpectedly and they wrote of seeing these shadows on the inside of their arteries where it was obvious plaques had been. Their rates of heart attacks and strokes reduced fairly dramatically almost overnight and as soon as they shipped off all the meat and cheese to the front lines. It is one of the few examples of a population being forced off animal products and could not be replicated easily today. The data of reduction of death by heart attack and stroke seems pretty unequivocal. Correlation vs causation is always tough, but It shows what it shows.
😮😮😮😮I'm a 57 year old female, pre-diabetic and 100 pounds overweight. My calcium score is zero. A friend of mine is in his 70s. He was at a normal weight and had normal cholesterol. No symptoms of heart disease. He decided to get a cardiac calcium test. His score was 1500!!! Upon further more evasive testing it was discovered that he needed a triple bypass!!!!
It is the luck of the draw. Trust me. 😉
65 yr old female. Thin. Very physically active. Watch my diet closely. Cant take statins. Take Praluent injection and zetia. . Calcium score of 700. Failed a stress PET scan. Headed to cath lab. Cath showed no sign of blockage. 20% narrowing in one place. Said that was normal for my age. Any thoughts?!
Defining obstructive CAD as 50% is an ancient definition. Obstructive CAD causing symptoms typically require a stenosis of at least, again at least 70%.
Awesome video as always.. Great work doc!! 👌👌
Pricing of CTA as mentioned @ 11minute mark. Dr. Dayspring says the CT Angiogram test is 10x priced higher than the CAC test. In my area, Jax, Fl., the CAC test is $99, while the CTA scan w/ CAC score is $350. I checked with my insurance company and found that the CTA test would cost $380 as a deductible.
I got mine score last week, 437. I will be 66 in March and eat very healthy. My doctor said it's herdity bc im not overweight and never smoked or drank, but occasionally, a drink she is setting me up with a cardiologist. I'm very nervous about it. My mom and dad both had heart problems. I do have high cholesterol, but I couldn't take statins made my whole body ache. They did ultra sound on neck arteries that test came by good .
Isn’t CT angiogram better? It shows non-calcified plaque
A helpful video indeed. The current problem is that cardiologists (and most doctors) do n ot take the time to educated the patient as thoroughly as this video. My calcium score is zero at 75 years old, but the cardiologist has prescribed a statin due to high cholesterol. I'm told I need the statin if I want to live to be 90 years old. So, now I have urination side effects. Maybe my body likes high cholesterol? Or maybe Zetia is a better alternative? So many questions with so few answers.
Dr. Dayspring--Great information. Last year after a friend had a heart attack I asked my Doctor what test might show if I was at risk. I asked him for a CRC test. Went and the results were 2200. My doctor said it was the second highest in his history He ordered a Nuclear stress test which I completed and it revealed no blockages. My doctor only recommended diet and exercise.
I researched anything that could help -- I added Vitamin K2 and Berburine. My doctor has no further recommendations but to get further scans every 3 months. Recently I researched Nattokinase which has proven to reduce plaque. I sent the information to my Doctor waiting on response. Should I see a specialist?
Blood pressure is always a little low, cholesterol currently 160 on stain, 6'-2" 260
Calcium score doesn't make sense to me. vigorous exercise among middle age to elderly increases coronary calcium as do statins. I read that coronary calcium is less important when exercising because exercise helps prevent heart attacks and statins are good because the calcification helps to prevent the plaque from rupturing. I also read that coronary calcium score doesn't mean there is lipid or cholesterol build up since you cannot see the beyond the calcium. Either calcium in the coronary arteries is good or bad--how could it be that sometimes its OK and other times its bad? Furthermore, I have read studies that say that vitamin K2 decreases coronary calcium. Is that correct?
My diet has been near perfect (low carb, only healthy fats, lots of salmon, sardines and grass-fed beef and eggs) for the past few year and I'm metabolically healthy, yet my CAC score went up from 26 (age 49) to 118 (age 52) over the past two years. I have no idea what to do with all the conflicting information.
This a really good explanation of CAC
But now there is a study saying statins increase calcium score. What is your take on that?
And I should watch the entire clip
The fact that I am an MD and I tell my pt that CAC is not accurate and they bring conspiracy theory and big pharma nonsense ,it’s so frustrating!!!
😉
I had a CCA done but didn’t get a total score. I had 3 areas that were positive. They were measured in percentages, like 1-20%. So do I add the three numbers up to come up with a total. Would my total be 3-60?
Wish I could like this multiple times!
I had a score of 0 on the cac but the report stated "punctate calcium noted in aorta" as a sidenote. I wonder why they didn't make an issue out of this. It doesn't sound great to me unless I'm missing something?
My story is a bit different. 10 years ago at age 55 I had a routine cardiac calcium score test result of 721. I was referred to a cardiologist who did a heart cath two days later. The result was 40-50% stenosis at the diagonal branch with minimal luminary stenosis in all the other vessels. I was already taking 20 mg of atorvastatin and 81mg aspirin for the previous 9 years but the statin was increased to the 80mg max dose after the calcium score/heart cath. No side effects from the statins. Since then, yearly cardiologist appts, two nuclear stress tests and I can still run 6 miles like greased lightning. Obviously the calcium plaque was not in my arteries. I am told worst case scenario would be a stent if it gets worse. I’m told that statins stabilize the plaque and actually causes it to ‘regress’ a bit. So, a high calcium score is not all that it’s cracked up to be but it needs to be followed up on. My $.02
Well presented & very useful information. Many thanks
Hope you get this. What is the link to the one page primer?
Learning new stuff all the time with you, thx!!
Where is stats and how much does statin decrease incident of cardiac arrest?
Speaking of calcium, we need a whole video dedicated for calcium from plants.🙈
It really sucks that it can be so hard to get a CAC or Apo-B test... If you have lousy insurance, getting more than a basic (and of limited use) cholesterol test is difficult or impossible, unless you offer to pay out of pocket.
My CAC was $125 out of pocket in April. I finally convinced my Physician's Assistant to give me a script for the CAC and an advanced lipid panel I requested. She was very hesitant and seemed annoyed that I asked multiple times.
What’s the difference between a cac test and a ccat test?
Endothelial dysfunction is a good marker for heart health?
how would you measure it? FMD?
@@NutritionMadeSimple EndoPAT combined with Lp PLA-2 & Lp(a)?
Excellent video. Very informative. 👍🏽💯🔥✔
What about taking vitamin K2 / MK7 and D3 while taking a statin? For example if someone had a moderate risk CAC of 200. I would like to hear your thoughts on that.....really appreciate the data-based approach in your videos.
see th-cam.com/video/nkPEfVzm6io/w-d-xo.html
So appreciate the solid and up-to-date scientific information you share here. If anyone knows of lipidologists or cardiologists in NYC who are also up-to-date on ApoB/LP(a) as key risk markers to address, and whose practices are informed accordingly, can you share their names with me? Most I have found so far are patronizing about it and are not convinced it is important. It is hard as an active and informed patient to find doctors who are too!
Curious if you ever found any? IM on Long Island, Dr wants to put me on statin for 330 CT score but LDL was only 95. So far Im resisting. Thanks for any info.
I’m 46 and a year ago found out I have a CAC of 146. Big surprise. I have used this information to radically change my diet and lifestyle. Two cardiologists have refused to refer me to get tested to look for soft plaques. I don’t want to take statins but I understand it is likely a must. My cardiologist agrees with my plan to take a low dose statin every other day to start.
I found your video very informative, but there is some information that the other doctor said about not being able to get a CTA readily I’m on Medicare advantage and I had one done four years ago at Cedar Sinai in Los Angeles. I did that one just before I went onto Medicare actually, and I paid for that one myself but I’ve had two subsequent ones because of familial issues and I never had any issues getting it paid for by Medicare whatsoever and of course it’s a very good scan when you have the dye done as well, but I just wanted to make that note I don’t think it’s that difficult to go ahead and get one done and get it paid for it to be honest with you
What is an APoB? "Mel" keeps saying that but I don't see it defined! Sounds really important!
Another telling example is calcium score among athletes that is higher than average but obviously athletes are not at higher risk of heart attack. They tend to have fewer soft plaques despite higher CAC.
I wouldn't be so sure with that statement: "obviously athletes are not at higher risk ". Comparing people who exercise with potato couches is not the way . Extended exercise and lifelong overtraining doesn't lead to longevity.Many Athletes by themselves know that.
@@georgeborb2848 splitting hair, I'm talking about normal recreational athletes that are the vast majority. I'm aware that long term very intensive activity may cause some increase in heart blocks and atrial fibrillation, but to my knowledge there is no demonstrated increase in cardiovascular events or mortality linked to atherosclerosis. That's what we are talking about here.
Interesting if extremely fit run ultra marathons eat well and 52 resting heart rates 50 and to my shock I was 13
I went in for an angiogram, and my cardiologist found all kinds of calcified blockages, he said it was from dialysis, and i think warfarin contributed to it too, im 33. Going in to have 2 more stents placed soon
Can you post a link to the studies that demonstrate that statins increase coronary calcium and thus CAC?
I have heard several online cardiologists mention this but my cardiologist wants the studies. Evidently, he is not aware of this phenomena or does not believe it. Thank you
Just got it done. I'm 73, got a score of 1. It cost me $99. Insurance didn't cover it.
Had read if gene is 9p21 that statins can make worse , is there info on what may behelpful (also Lpa ). Appreciate this information on Ca score and age. Would a INTIMA (neck artery ultrasound) be useful and you mentioned legs can have clogging ?