I'm a 59 year old male and just received a CAC score of 487 with 309 in the LAD. My Lipid Panel is: TRI 71; HDL 90; LDL 135; TRI/HDL 0.8; GLU 90; HA1C 5.1. I'm on a Low Carb Diet and have lost 25 pounds since Sept 2023; low BMI and excersize daily. Now, the Doctor wants to put me on statins to control my "risk" of a coronary event due to my high LDL and high CAC. I would like to know what is really going on INSIDE of my arteries first. Does this make sense?
Great work on healthy lifestyle and low BMI… Given that your CAC is high especially in LAD, statins would likely help regress some of that plaque build up… statins don’t only reduce cholesterol, but they stabilize plaque already there (as a result it’s then less likely to rupture and cause MI) but statins are also anti inflammatory and can reduce likelihood of further plaque deposits and reduce current volume of plaque … You basically want to slow down, or, hopefully stop progression of plaque build up or regress/reverse it… You’d also want to ask your doc to check your Apo B and Lipoprotein a (aka Lp little a) … Good luck!!
@c103110a Personally, on top of Apo B and Lp (a) suggested by @DrProfX, I would ask your cardiologist to investigate that high HDL 90. It may not be fully fine... Search for 'Dysfunctional HDL'. and 'HDL levels harmful' in youtube.
There are new schools of thought that say cholesterol levels are not being properly studied and that high HDL /triglycerides ratio numbers are more important then LDL levels small and large particles are really tested for. Just wondering what your thought is on this.
It's really about focal vitamin C deficiency, not cholesterol. Reversing my coronary artery calcium with the Linus Pauling Heart Protocol verified by CAC.
@bartrobinson2103 Hardly, otherwise, how would my 30% CAC reversal be explained with a 98 triglycerides and an HDL of just 36, LDL of 124. I follow Dr. Thomas Levy's advice from his book "Stop America's #1 Killer" Proof that the Origin of All Coronary Heart Disease is Clearly Reversible Arterial Scurvy. Have you had a CAC? Are you reversing it?
It's certainly good to have a decent ratio, but it's not the answer to heart disease reversal I have no concerns with high cholesterol when a CAC is in regression I eat a Keto diet sugar and grain free but I'm not religious about it. On the Pauling Protocol, I have 30 grams of Vitamin C in divided doses per day with 8 grams of Lysine and Proline.
At 11:25: Does the NNT of 100 people taking statins means there's a good result for 1 patient? Is this correct? If so, seems like statins are the real waste of money.
Excellent presentation. I really like point #5 about the risks of unnecessary intervention. This was about to happen with me, as follows: 3.3 years ago I had a CAC of 160. I was asymptomatic but Cardiology PA recommended echocardiogram and nuclear stress which I passed. At the time I felt these were both overkill but did them anyway. Fast forward to last month, I had another CAC, this time 200 and still asymptomatic (incidentally that works out to a 7.1% annual progression, which I understand to be pretty decent). Cardiology NP immediately wanted another nuclear stress test and also recommended another echocardiogram because a "small pericardial effusion" was noted on the CT report . I immediately refused the stress test and, though it's still scheduled, I'm probably going to cancel the echo. In fact I'm going to find a new cardiologist. I've been to this practice 7 times now (plus visits for imaging) and I've never seen an actual doctor, only PA and NP. My suspicion is that PAs and NPs increases the rate of unnecessary intervention simply because they err on -- what they think is -- the side of caution and, perhaps, eagerness to put what they've learned in school to work. Especially in younger, less experienced, (NP/PA) providers, I think their mindset is one of "getting the right answer on the exam" and not so much of doing what is right for the patient based on clinical experience. It also occurred to me that these subordinate practitioners are at much higher risk of getting into trouble for _not_ ordering a test than for ordering a questionable/unnecessary test - especially since the practice does the echocardiograms, stress tests, and CT scans in-house. If I had done the stress test I could easily see the slightest abnormality being used to justify a cath and possibly a stent, which I already knew is almost (maybe never) helpful in asymptomatic patients. Thanks for the great presentation!
In the USA it would seem most medical practices have gone to utilizing PA’s & NP’s way over the amount of Docs that actually see patients….my guess is its a money thing & yes to your point these clinicians would much rather err on the side of what they feel is caution….hard to beat good ol’ on the job experience after years and years of practice!!
Great overview, but one thing should be highlighted: Agatston score or coronary artery calcium (CAC) score was assessed in the Framingham heart study on ASYMPTOMATIC individuals, therefore, it only should be considered for risk estimation. If someone is SYMPTOMATIC, that is a complete different story...
It depends on your situation -- i.e. symptoms, results from other tests, risk group, etc. It shouldn't be a reflex to always get a CTA in this setting though.
Thank you! I was thinking in terms of artefacts, a cardiologist told me that over 400 the artefacts are too strong to really assess stenoses. Would you agree?
If you have been taking a statin, that will increase your Calcium score. Statins function to stabilize soft plaque by calcifying it. This is much safer as calcified plaque is far less likely to rupture resulting in a heart attack, stroke or sudden death. This is actually good. So an increased calcium score suggests the healing process of unstabilized plaque. So, an increase calcium score is not always bad.
Interesting. 63 yrs old, 766 cac. No symptoms. When’s to cardiologist and he ordered carotid artery echo and heart echo and both came back very good. He said stay in your statin and aspirin like I have been since 38 yrs old. Looks like simvastatin is doing its job!
@@johndanczak I certainly don't consider a higher calcium score as healing! Reversing my CAC Score from 660 to 458 in 20 months. This coming August I'm hoping to have it less than 300. Using the Linus Pauling Heart Protocol.
@ if you don’t consider it healing, you may not fully understand the process. The healing is stabilizing unstable very dangerous plaque. There are no know therapies that can reliably reverse calcium score, unfortunately. If you have a positive Ca score, you have plaque. The calcium score indicates that, but should not be the immediate concern. The concern is how much calcium “soft/unstable” plaque you currently have. This is the plaque that can rupture and lead to a cardiac event, stroke or sudden death. The “reversal” of Ca does nothing to rid soft plaque, and that’s what will kill you. A CIMT is a test that can measure the amount of soft plaque. That’s the critical number, not Ca score.
@johndanczak I do fully understand the process. I prefer to look at it from Dr. Thomas Levy's and Dr. Mathis Raths point of view. I have been researching for the last 4 years. My Cartoid arteries are perfectly clear. My last CAC was with contrast. No real plaque burden seen. High dose vitamin C 20-30 grams per day in divided doses is capable of dissolving calcium and plaque. It is also used to build collagen, which is used to properly repair the artery. While Lp-a is used for vitamin C deficiency. It's a poor substitute, and it binds to the exposed damaged Lysine strands and further attracts LDL along with other fats. The Linus Pauling Heart Protocol uses Lysine as a binding inhibitor to neutralize Lp-a, making vitamin C more effective in getting the artery repaired correctly. I would never use a statin as it can kill plants 🪴 the same way it lowers cholesterol. It's literally a herbicide.
My first Calcium score was 432, a month later after taking Statin 20mg it was 509. At the same time CTA was done which stated at LAD (left main) mild to moderate calcific atherosclerosis noted. This is non obstructive per CT-FFR. At left Anterior, there is moderate predominantly calcific atherosclerosis with 40-70% luminal stenosis. Again this is non obstructive by CT-FFR. Question is what is correct, a 40-70% Stenosis noted or CT-FFR revealing non obstructive. In short Stenosis vs non obstructive per CT-FFR? My LDL is 100, HDL 46, no diabetes
A 78-point increase of calcium in 1 month! Are you kidding me? I'm glad I don't take a statin. Reversing my coronary artery calcium. CAC 660 to 458 in 20 months using the Linus Pauling Heart Protocol. By this coming August, I'll have another CAC, and I'm expecting it to be less than 300.
Ok I just got my calcium CT artery score results back. Mine is 449 and now I am freaking out. I stopped statins awhile ago and for the first time in a long time I have clearer mental clarity than ever before. Do I need to go back on them? Am I going to drop over tomorrow with this high score?? Do I need to see a cardiologist like, yesterday? I just recently lost 70 pounds over this past year and feel better than ever. I am not a smoker. My father passed at 32 from massive heart attack. I am fused up and down my spine and also have a spinal stimulator in my back so I am limited for exercise. Anxiety is now through the roof...help!!!
Pŕsident Clinton had a score of 1000 when he had his heart attack. At a increase of %25 per year his score should be around 4000 now. Still alive and kicking.
@sheddkkhan6758 you are correct . He can reverse it. I reversed my 660 by 200 points to 458. I'm 69 on no medications using the Linus Pauling Heart Protocol.
I am a victim of Key Point 5! I had a 951 CAC I ended up getting a PCI To diagnose risk and they placed 4 stents. During the procedure I had a dissection in my LAD, and that led to a 4th unplanned stent. When you are on your back and they tell you you need it You say, 'yes, please". The report stated I had 50-80% blockages. I got the CAC because I had high LDL due to being on a keto diet.
@@BethGalloway-k4l The Pauling Heart Protocol. I use all powders. High dose ascorbic acid vitamin C 20-30 grams per day in divided doses. Lysine and Proline 3-4 grams each 2x per day. Throw in magnesium glycinate 800mg in divided doses per day as when magnesium is up Calcium is down.
Not sure why you suggest at this when they cause more trouble than they're worth there are many supplements which I study which are as good as or better than Stats and don't have any side effect
I certainly wouldn't take a statin as they just increase coronary calcium all in the name of plaque stabilization, but they don't stop heart attacks and they are considered a herbicide they kill plants so I don't care to poison myself.
Further, you are right about supplements with no side effects. In fact, I am on the Linus Pauling Heart Protocol, reversing my coronary artery calcium verified by CAC.
Hmm, food for thought. As my brother had/has serious heart disease for which they can treat only partially it is so far gone, and since out oif pocket it is only CAD100 for me in Thailand I am tempted to get it done. However, the temptation is just to skip it and instead eat and live as if I have heart disease.
@hermes8258 That's the question: How much do you have? It should be remembered that the score is compounding! This means it can easily double in 5 years. Further treating it with a Statin can double the progression rate. I'm reversing mine as verified by CAC. So getting at it early is better than late. Mine has gone from 660 to 458 on the Linus Pauling Heart Protocol in 20 months.
I am a 70 yr old woman with no symptoms but do have high cholesterol n triglycerides. I have a coronary Calcium score scan scheduled should I take the chance? I have just survived cancer will be 3 yrs in I am a 70 yr old woman with no symptoms but do have high cholesterol n triglycerides. I have a coronary Calcium score scan scheduled should I take the chance? I have just survived cancer will be 3 yrs in Oct!
Absolutely! It is the best predictor of a future cardiac event. There is no question about it! I have had 3 of them. My last one was with contrast, which was necessary to see soft plague as a standard CAC can not see soft plague.
Hi may I ask how you get doctor to write the script for you to do such test? My cholesterol is high but doctor won’t let me take this test, instead just prescribe me satin
@@JamesLai all I did was ask my Dr that I wanted to test for anything that might cause a problem with my heart like plaque etc. I was prescribed a statin but refused to take one and will not be forced to. I will do other methods to lower my cholesterol if need be. If your Dr refuses to help you in the way you feel comfortable then find you another doctor. I would!
@JamesLai In the USA, a script isn't required. When doctors put you on a Statin, they feel the risk assessment of a CAC no longer applies as the statin is used to calcify the soft plague considered to be the more dangerous. Calcification is considered stabilization. Unfortunately, a statin compared to placebo was just a 1% improvement 2% vs. 3% of a future cardiac event 😕
So personally, I am reversing my CAC Score, which would never happen taking a statin. As the statin just calcifies. I am on the Linus Pauling Heart Protocol and have reversed my 660 CAC Score to 458 in 20 months, said to be impossible!
I’m a 68 year old Indian man with a Cardiac Score of 103. My total cholesterol is 260, my HDL is 77, my LDL is 154. My apo B and apo A are normal levels. My Triglycerides is 19. My blood pressure is 103/63. I exercise (strength training or cardio) for one hour a week and eat a very healthy diet. My body fat is 11% and my visceral fat is 3%. My cardiologist has advised taking a statin. What do you think?
I am so confused by your statement at 7:00. Nothing I have seen affirms that statins make any appreciable difference in preventing heart attacks. In fact, LDL levels are not correlated in any way with heart attacks. From what I understand, this is primarily a sugar/inflammation issue, not an LDL issue. What evidence/studies are you referencing to make such a statement? Make sure you're not citing evidence from studies created by statin makers.
@@S.H-c6g would seem logical, but in the wrong population it likely does more harm than good. A lot of other examples like that in medicine - it seems logical to just get the test and information from first order thinking. But second order considerations - we learn that statistically it would be more likely to harm than help you. There’s no re dos on net harm either
I’m 50… had cac of 185….. question is I drank 20oz Starbucks black coffee in waiting area for test…didn’t know not to do this. Could this give me false high or anything like that?
I find the argument here to be outrageous and irresponsible. First of all, cost (especially modest cost) should not be part of any argument in a 1st world country if spending money can save a life. And there can be absolutely no doubt that visualizing a plaque of any size can serve as a wake up call and encourage proactive prevention before things become too late. The costs of CAC and followup tests are less than the difference people spend on a "premium package" for a new car. What's more important: leather seats or preventative cardiac care? Or to look at it from a population-wide ethical angle: how can we accept cardiologists earning an average salary of 517K (current USA statistic) while arguing that a few hundred to few thousand bucks is too much to spend on a patient getting preventative radiology? Second, the idea of overtreatment is being misplaced. Any positive test can create anxiety and lead people to overtreat a disease. But that's not the fault of the CAC test; it's the fault of medical professionals overresponding to it. The problem is not the initial test but the subsequent behaviors. Third, any atherosclerosis SHOULD be monitored. It's not likely that a person with any atherosclerosis will have, say, a 0.001% risk of a heart attack over 10 years. The standard equations would be more likely to give them a 1% to 5% chance, even if their plaque is small. 1% or 2% may not mean much to you, but that's 1 in 100 or 1 in 50 people having a heart attack, stroke, etc. I'm sure that means something to them. It's good to know you have even a 1% chance, so that you and your doctor can keep that from becoming 2%. That is absolutely a legitimate goal that tests like CACs create in many people who otherwise would do nothing to improve their risk until some more of their train cars went off the rails. We're talking about heart attacks, strokes, and death here; we're not not talking about risk of a skin rash flaring up. Fourth, there's a bit of radiation alarmism here. A 1 to 2 mSv exposure is very small. Again, this is not a good argument against CAC; it's an argument against obsessive, over-frequent repeated CACs. I'm also deeply perplexed by your mention of lung nodules possibly leading to a cat scan. Really? How is that a negative if a pulmonologist thinks there's a chance of lung cancer? Again, only a negative if the followup care if inappropriate, and that again is an issue with the followup care, not the CAC.
- The argument is not the cost. It's that there is zero evidence for any true outcome benefit, EVEN in the 'best case' intermediate risk subset... AND (by the way) it costs a lot. I still give the test the benefit of the doubt in some groups. Of COURSE, preventative cardiac care is much more important than a nicer car. But, even taking cost out of it completely, you would need evidence for actually benefiting preventative care before recommending it on a population level. You are free to do what you personally might want or need for a 'wake up call' -- but if population level intervention result in net zero benefit then it shouldn't be suggested that everyone gets it. This is one of the many reasons why the US has the most expensive health care systems and still poor outcomes -- reaching for the highest tech solutions that sound logical, but have zero evidence for them. There are potential unintended consequences with any test or intervention that can only be accounted via randomized control trial. Things often don't work as neatly or as linear as we'd like. I encourage you to watch Vinay Prasad's vide on mammography, as a solid example. It sounds logical that mammograms should save many many lives. But, unfortunately, its not so simple. I wish it was. - Overtreatment is not the 'fault of the test', but what happens to patients after a test due to its results in the real world must be considered before recommending people have it. The best way to do this is via randomized control trial. Simple example: if 10,000 low-risk people were randomized to get a CAC score CT, and 10,000 to standard of care -- and then after some follow-up 100 died of MI in the standard of care group, and 98 died of MI in the CAC group PLUS 2-3 from complications during unnecessary interventions... unfortunately the intervention of a CAC score CT did not save any lives. This is just a simplified example to illustrate the concept (with made up numbers), but hopefully you get the point. It would be great if someone could do an RCT on this very topic. - The point is not that we shouldn't be monitoring risk. We must. The point is that the incremental value of this test must outweigh the stated risks to be something that is actually beneficial to a particular group of patients. - I say that the dose is extremely tiny and not really a factor. Incidental findings is a whole other discussion.
@@navigatingradiology You are pointing out an important issue with the US healthcare system: we spend a lot of money but don't have the outcomes to show for it. But I'd argue that's because we act too late, not too early. In the case of heart disease, we have a huge number of people eating McDonalds, smoking, having a few beers every night, and sitting around at work and then at the TV. So we wait until they have a heart attack at 55, then spend a huge amount of money to try to save their life and extend it. (Insert less dramatic lifestyles and outcomes here.) The value of CAC and preventative cardiology in general is that it counters this problem, not worsens it. A CAC score is a wakeup call to people who otherwise would continue their path toward unnecessary progression of disease. Agree a randomized trial would be helpful here, but that trial would need to be set up to measure the effect of all the elements in the interventional cascade--not just the CAC, but everything that comes after it. And the trial would need to segment physicians and/or care strategies into several groups to get useful results. It's not just a question of having a test vs not; it's a question of what we do with the test. The problem, of course, is that this is not realistic. The trial would probably have to occur over decades and in a huge population to be mathematically powered to show differences between all the courses of action. Meanwhile, the technologies will have evolved tremendously, especially now as we enter the era of nanotechnology, gene therapy, AI, etc. So I don't think we're ever going to have such a trial, and even if we do, the results will arrive after the interventions have evolved. Meanwhile, even randomized trials have tremendous limitations. For example, it's taken half a century to realize that all the trials about saturated fat accelerating heart disease may be wrong, or at least somewhat wrong. There are just too many variables affecting heart disease prevention, and so many things we don't yet understand, to think that somehow one more study can decide for an entire population how to manage their heart health. This is another reason individuals should be empowered to make their own decisions and not told a relatively low-cost test is too costly.
I'm a 59 year old male and just received a CAC score of 487 with 309 in the LAD. My Lipid Panel is: TRI 71; HDL 90; LDL 135; TRI/HDL 0.8; GLU 90; HA1C 5.1. I'm on a Low Carb Diet and have lost 25 pounds since Sept 2023; low BMI and excersize daily. Now, the Doctor wants to put me on statins to control my "risk" of a coronary event due to my high LDL and high CAC. I would like to know what is really going on INSIDE of my arteries first. Does this make sense?
Great work on healthy lifestyle and low BMI…
Given that your CAC is high especially in LAD, statins would likely help regress some of that plaque build up… statins don’t only reduce cholesterol, but they stabilize plaque already there (as a result it’s then less likely to rupture and cause MI) but statins are also anti inflammatory and can reduce likelihood of further plaque deposits and reduce current volume of plaque … You basically want to slow down, or, hopefully stop progression of plaque build up or regress/reverse it…
You’d also want to ask your doc to check your Apo B and Lipoprotein a (aka Lp little a) … Good luck!!
@c103110a Personally, on top of Apo B and Lp (a) suggested by @DrProfX, I would ask your cardiologist to investigate that high HDL 90. It may not be fully fine... Search for 'Dysfunctional HDL'. and 'HDL levels harmful' in youtube.
lower ldl c to < 55mg /dl and aspirin
I reversed my CAC with the Linus Pauling Heart Protocol 660 to 458
Hope you saw a cardiologist and got a cardiac catheter
There are new schools of thought that say cholesterol levels are not being properly studied and that high HDL /triglycerides ratio numbers are more important then LDL levels small and large particles are really tested for. Just wondering what your thought is on this.
It's really about focal vitamin C deficiency, not cholesterol. Reversing my coronary artery calcium with the Linus Pauling Heart Protocol verified by CAC.
correction.. It's
Triglycerides/ HDL ratio.
@bartrobinson2103 Hardly, otherwise, how would my 30% CAC reversal be explained with a 98 triglycerides and an HDL of just 36, LDL of 124. I follow Dr. Thomas Levy's advice from his book "Stop America's #1 Killer" Proof that the Origin of All Coronary Heart Disease is Clearly Reversible Arterial Scurvy.
Have you had a CAC?
Are you reversing it?
It's certainly good to have a decent ratio, but it's not the answer to heart disease reversal I have no concerns with high cholesterol when a CAC is in regression I eat a Keto diet sugar and grain free but I'm not religious about it. On the Pauling Protocol, I have 30 grams of Vitamin C in divided doses per day with 8 grams of Lysine and Proline.
Thank you very much for creating and sharing. This is exceptionally beneficial and greatly appreciated.
At 11:25: Does the NNT of 100 people taking statins means there's a good result for 1 patient? Is this correct? If so, seems like statins are the real waste of money.
Excellent presentation. I really like point #5 about the risks of unnecessary intervention.
This was about to happen with me, as follows:
3.3 years ago I had a CAC of 160. I was asymptomatic but Cardiology PA recommended echocardiogram and nuclear stress which I passed. At the time I felt these were both overkill but did them anyway.
Fast forward to last month, I had another CAC, this time 200 and still asymptomatic (incidentally that works out to a 7.1% annual progression, which I understand to be pretty decent). Cardiology NP immediately wanted another nuclear stress test and also recommended another echocardiogram because a "small pericardial effusion" was noted on the CT report .
I immediately refused the stress test and, though it's still scheduled, I'm probably going to cancel the echo. In fact I'm going to find a new cardiologist. I've been to this practice 7 times now (plus visits for imaging) and I've never seen an actual doctor, only PA and NP.
My suspicion is that PAs and NPs increases the rate of unnecessary intervention simply because they err on -- what they think is -- the side of caution and, perhaps, eagerness to put what they've learned in school to work. Especially in younger, less experienced, (NP/PA) providers, I think their mindset is one of "getting the right answer on the exam" and not so much of doing what is right for the patient based on clinical experience.
It also occurred to me that these subordinate practitioners are at much higher risk of getting into trouble for _not_ ordering a test than for ordering a questionable/unnecessary test - especially since the practice does the echocardiograms, stress tests, and CT scans in-house.
If I had done the stress test I could easily see the slightest abnormality being used to justify a cath and possibly a stent, which I already knew is almost (maybe never) helpful in asymptomatic patients.
Thanks for the great presentation!
In the USA it would seem most medical practices have gone to utilizing PA’s & NP’s way over the amount of Docs that actually see patients….my guess is its a money thing & yes to your point these clinicians would much rather err on the side of what they feel is caution….hard to beat good ol’ on the job experience after years and years of practice!!
Great overview, but one thing should be highlighted:
Agatston score or coronary artery calcium (CAC) score was assessed in the Framingham heart study on ASYMPTOMATIC individuals, therefore, it only should be considered for risk estimation. If someone is SYMPTOMATIC, that is a complete different story...
Is it useful/would you recommend to do a coronary angiogram of a patient with a calcium score of over 400?
It depends on your situation -- i.e. symptoms, results from other tests, risk group, etc. It shouldn't be a reflex to always get a CTA in this setting though.
Thank you! I was thinking in terms of artefacts, a cardiologist told me that over 400 the artefacts are too strong to really assess stenoses. Would you agree?
you can reverse it
If you have been taking a statin, that will increase your Calcium score. Statins function to stabilize soft plaque by calcifying it. This is much safer as calcified plaque is far less likely to rupture resulting in a heart attack, stroke or sudden death. This is actually good. So an increased calcium score suggests the healing process of unstabilized plaque. So, an increase calcium score is not always bad.
Interesting. 63 yrs old, 766 cac. No symptoms. When’s to cardiologist and he ordered carotid artery echo and heart echo and both came back very good. He said stay in your statin and aspirin like I have been since 38 yrs old. Looks like simvastatin is doing its job!
@@R8GT Except for the long term side effects of Simvastatin! But, they might have drugs to manage those too!
@@johndanczak I certainly don't consider a higher calcium score as healing! Reversing my CAC Score from 660 to 458 in 20 months. This coming August I'm hoping to have it less than 300. Using the Linus Pauling Heart Protocol.
@ if you don’t consider it healing, you may not fully understand the process. The healing is stabilizing unstable very dangerous plaque. There are no know therapies that can reliably reverse calcium score, unfortunately. If you have a positive Ca score, you have plaque. The calcium score indicates that, but should not be the immediate concern. The concern is how much calcium “soft/unstable” plaque you currently have. This is the plaque that can rupture and lead to a cardiac event, stroke or sudden death. The “reversal” of Ca does nothing to rid soft plaque, and that’s what will kill you. A CIMT is a test that can measure the amount of soft plaque. That’s the critical number, not Ca score.
@johndanczak I do fully understand the process. I prefer to look at it from Dr. Thomas Levy's and Dr. Mathis Raths point of view. I have been researching for the last 4 years. My Cartoid arteries are perfectly clear. My last CAC was with contrast. No real plaque burden seen. High dose vitamin C 20-30 grams per day in divided doses is capable of dissolving calcium and plaque. It is also used to build collagen, which is used to properly repair the artery. While Lp-a is used for vitamin C deficiency. It's a poor substitute, and it binds to the exposed damaged Lysine strands and further attracts LDL along with other fats. The Linus Pauling Heart Protocol uses Lysine as a binding inhibitor to neutralize Lp-a, making vitamin C more effective in getting the artery repaired correctly. I would never use a statin as it can kill plants 🪴 the same way it lowers cholesterol. It's literally a herbicide.
Many thanks for your clarity and expertise in explaining this important topic.
EXCELLENT PRESENTATION! Mil gracias ❤️❤️❤️❤️❤️
the difference between English/Canadian/Australian Drs and USA based Drs is telling. Thank you for making this video
My first Calcium score was 432, a month later after taking Statin 20mg it was 509. At the same time CTA was done which stated at LAD (left main) mild to moderate calcific atherosclerosis noted. This is non obstructive per CT-FFR.
At left Anterior, there is moderate predominantly calcific atherosclerosis with 40-70% luminal stenosis. Again this is non obstructive by CT-FFR.
Question is what is correct, a 40-70% Stenosis noted or CT-FFR revealing non obstructive. In short Stenosis vs non obstructive per CT-FFR? My LDL is 100, HDL 46, no diabetes
A 78-point increase of calcium in 1 month! Are you kidding me?
I'm glad I don't take a statin. Reversing my coronary artery calcium. CAC 660 to 458 in 20 months using the Linus Pauling Heart Protocol. By this coming August, I'll have another CAC, and I'm expecting it to be less than 300.
Thank you for the excellent explanation.
Links to any data showing statins decrease /prevent CVD?
Ok I just got my calcium CT artery score results back. Mine is 449 and now I am freaking out. I stopped statins awhile ago and for the first time in a long time I have clearer mental clarity than ever before. Do I need to go back on them? Am I going to drop over tomorrow with this high score?? Do I need to see a cardiologist like, yesterday? I just recently lost 70 pounds over this past year and feel better than ever. I am not a smoker. My father passed at 32 from massive heart attack. I am fused up and down my spine and also have a spinal stimulator in my back so I am limited for exercise. Anxiety is now through the roof...help!!!
Because of your family history I would see a cardiologist. I’m in a similar situation. I see a cardiologist this week.
Statins significantly reduce the risk of heart attack and death? Not in absolute terms.
Yes, they do.
I had a CTA and scored 4300. I asked the Dr how much time do I have left. I'm a 68 yr old male, with type 1 Diabetes.
Pŕsident Clinton had a score of 1000 when he had his heart attack. At a increase of %25 per year his score should be around 4000 now. Still alive and kicking.
you can reverse it
@@sheddkkhan6758really? How?
@sheddkkhan6758 you are correct . He can reverse it. I reversed my 660 by 200 points to 458. I'm 69 on no medications using the Linus Pauling Heart Protocol.
@sheddkkhan6758 If he really wanted to reverse it fast, I would be on NanobacTX in a heartbeat!
I am a victim of Key Point 5! I had a 951 CAC I ended up getting a PCI To diagnose risk and they placed 4 stents. During the procedure I had a dissection in my LAD, and that led to a 4th unplanned stent. When you are on your back and they tell you you need it You say, 'yes, please". The report stated I had 50-80% blockages. I got the CAC because I had high LDL due to being on a keto diet.
@@ellocodos I'm on a Keto diet and have reversed my 660 CAC using the Linus Pauling Heart Protocol to 458 in 20 months.
Please tell us what that protocol is.
@@BethGalloway-k4l The Pauling Heart Protocol. I use all powders. High dose ascorbic acid vitamin C 20-30 grams per day in divided doses. Lysine and Proline 3-4 grams each 2x per day. Throw in magnesium glycinate 800mg in divided doses per day as when magnesium is up Calcium is down.
Not sure why you suggest at this when they cause more trouble than they're worth there are many supplements which I study which are as good as or better than Stats and don't have any side effect
I certainly wouldn't take a statin as they just increase coronary calcium all in the name of plaque stabilization, but they don't stop heart attacks and they are considered a herbicide they kill plants so I don't care to poison myself.
Further, you are right about supplements with no side effects. In fact, I am on the Linus Pauling Heart Protocol, reversing my coronary artery calcium verified by CAC.
Hmm, food for thought. As my brother had/has serious heart disease for which they can treat only partially it is so far gone, and since out oif pocket it is only CAD100 for me in Thailand I am tempted to get it done. However, the temptation is just to skip it and instead eat and live as if I have heart disease.
Howmuch cac you have
@hermes8258 That's the question: How much do you have?
It should be remembered that the score is compounding! This means it can easily double in 5 years. Further treating it with a Statin can double the progression rate. I'm reversing mine as verified by CAC. So getting at it early is better than late. Mine has gone from 660 to 458 on the Linus Pauling Heart Protocol in 20 months.
I am a 70 yr old woman with no symptoms but do have high cholesterol n triglycerides. I have a coronary Calcium score scan scheduled should I take the chance? I have just survived cancer will be 3 yrs in I am a 70 yr old woman with no symptoms but do have high cholesterol n triglycerides. I have a coronary Calcium score scan scheduled should I take the chance? I have just survived cancer will be 3 yrs in Oct!
Absolutely! It is the best predictor of a future cardiac event. There is no question about it! I have had 3 of them. My last one was with contrast, which was necessary to see soft plague as a standard CAC can not see soft plague.
Hi may I ask how you get doctor to write the script for you to do such test? My cholesterol is high but doctor won’t let me take this test, instead just prescribe me satin
@@JamesLai all I did was ask my Dr that I wanted to test for anything that might cause a problem with my heart like plaque etc. I was prescribed a statin but refused to take one and will not be forced to. I will do other methods to lower my cholesterol if need be. If your Dr refuses to help you in the way you feel comfortable then find you another doctor. I would!
@JamesLai In the USA, a script isn't required. When doctors put you on a Statin, they feel the risk assessment of a CAC no longer applies as the statin is used to calcify the soft plague considered to be the more dangerous. Calcification is considered stabilization.
Unfortunately, a statin compared to placebo was just a 1% improvement 2% vs. 3% of a future cardiac event 😕
So personally, I am reversing my CAC Score, which would never happen taking a statin. As the statin just calcifies. I am on the Linus Pauling Heart Protocol and have reversed my 660 CAC Score to 458 in 20 months, said to be impossible!
I’m a 68 year old Indian man with a Cardiac Score of 103. My total cholesterol is 260, my HDL is 77, my LDL is 154. My apo B and apo A are normal levels. My Triglycerides is 19.
My blood pressure is 103/63.
I exercise (strength training or cardio) for one hour a week and eat a very healthy diet. My body fat is 11% and my visceral fat is 3%.
My cardiologist has advised taking a statin. What do you think?
Sorry, I exercise one hour per day!
Get another cardiologist.
You can reverse
I am so confused by your statement at 7:00. Nothing I have seen affirms that statins make any appreciable difference in preventing heart attacks. In fact, LDL levels are not correlated in any way with heart attacks. From what I understand, this is primarily a sugar/inflammation issue, not an LDL issue. What evidence/studies are you referencing to make such a statement? Make sure you're not citing evidence from studies created by statin makers.
it's your life. no re-do's. get a calcium score for base line testing. anyone else advising against it = time for a new doctor 👍🏼
@@S.H-c6g would seem logical, but in the wrong population it likely does more harm than good.
A lot of other examples like that in medicine - it seems logical to just get the test and information from first order thinking. But second order considerations - we learn that statistically it would be more likely to harm than help you. There’s no re dos on net harm either
I’m 50… had cac of 185….. question is I drank 20oz Starbucks black coffee in waiting area for test…didn’t know not to do this. Could this give me false high or anything like that?
@@Jdpete11 no, would not affect
I find the argument here to be outrageous and irresponsible. First of all, cost (especially modest cost) should not be part of any argument in a 1st world country if spending money can save a life. And there can be absolutely no doubt that visualizing a plaque of any size can serve as a wake up call and encourage proactive prevention before things become too late. The costs of CAC and followup tests are less than the difference people spend on a "premium package" for a new car. What's more important: leather seats or preventative cardiac care? Or to look at it from a population-wide ethical angle: how can we accept cardiologists earning an average salary of 517K (current USA statistic) while arguing that a few hundred to few thousand bucks is too much to spend on a patient getting preventative radiology?
Second, the idea of overtreatment is being misplaced. Any positive test can create anxiety and lead people to overtreat a disease. But that's not the fault of the CAC test; it's the fault of medical professionals overresponding to it. The problem is not the initial test but the subsequent behaviors.
Third, any atherosclerosis SHOULD be monitored. It's not likely that a person with any atherosclerosis will have, say, a 0.001% risk of a heart attack over 10 years. The standard equations would be more likely to give them a 1% to 5% chance, even if their plaque is small. 1% or 2% may not mean much to you, but that's 1 in 100 or 1 in 50 people having a heart attack, stroke, etc. I'm sure that means something to them. It's good to know you have even a 1% chance, so that you and your doctor can keep that from becoming 2%. That is absolutely a legitimate goal that tests like CACs create in many people who otherwise would do nothing to improve their risk until some more of their train cars went off the rails. We're talking about heart attacks, strokes, and death here; we're not not talking about risk of a skin rash flaring up.
Fourth, there's a bit of radiation alarmism here. A 1 to 2 mSv exposure is very small. Again, this is not a good argument against CAC; it's an argument against obsessive, over-frequent repeated CACs. I'm also deeply perplexed by your mention of lung nodules possibly leading to a cat scan. Really? How is that a negative if a pulmonologist thinks there's a chance of lung cancer? Again, only a negative if the followup care if inappropriate, and that again is an issue with the followup care, not the CAC.
- The argument is not the cost. It's that there is zero evidence for any true outcome benefit, EVEN in the 'best case' intermediate risk subset... AND (by the way) it costs a lot. I still give the test the benefit of the doubt in some groups. Of COURSE, preventative cardiac care is much more important than a nicer car. But, even taking cost out of it completely, you would need evidence for actually benefiting preventative care before recommending it on a population level. You are free to do what you personally might want or need for a 'wake up call' -- but if population level intervention result in net zero benefit then it shouldn't be suggested that everyone gets it. This is one of the many reasons why the US has the most expensive health care systems and still poor outcomes -- reaching for the highest tech solutions that sound logical, but have zero evidence for them. There are potential unintended consequences with any test or intervention that can only be accounted via randomized control trial. Things often don't work as neatly or as linear as we'd like. I encourage you to watch Vinay Prasad's vide on mammography, as a solid example. It sounds logical that mammograms should save many many lives. But, unfortunately, its not so simple. I wish it was.
- Overtreatment is not the 'fault of the test', but what happens to patients after a test due to its results in the real world must be considered before recommending people have it. The best way to do this is via randomized control trial. Simple example: if 10,000 low-risk people were randomized to get a CAC score CT, and 10,000 to standard of care -- and then after some follow-up 100 died of MI in the standard of care group, and 98 died of MI in the CAC group PLUS 2-3 from complications during unnecessary interventions... unfortunately the intervention of a CAC score CT did not save any lives. This is just a simplified example to illustrate the concept (with made up numbers), but hopefully you get the point. It would be great if someone could do an RCT on this very topic.
- The point is not that we shouldn't be monitoring risk. We must. The point is that the incremental value of this test must outweigh the stated risks to be something that is actually beneficial to a particular group of patients.
- I say that the dose is extremely tiny and not really a factor. Incidental findings is a whole other discussion.
@@navigatingradiology
You are pointing out an important issue with the US healthcare system: we spend a lot of money but don't have the outcomes to show for it. But I'd argue that's because we act too late, not too early. In the case of heart disease, we have a huge number of people eating McDonalds, smoking, having a few beers every night, and sitting around at work and then at the TV. So we wait until they have a heart attack at 55, then spend a huge amount of money to try to save their life and extend it. (Insert less dramatic lifestyles and outcomes here.)
The value of CAC and preventative cardiology in general is that it counters this problem, not worsens it. A CAC score is a wakeup call to people who otherwise would continue their path toward unnecessary progression of disease.
Agree a randomized trial would be helpful here, but that trial would need to be set up to measure the effect of all the elements in the interventional cascade--not just the CAC, but everything that comes after it. And the trial would need to segment physicians and/or care strategies into several groups to get useful results. It's not just a question of having a test vs not; it's a question of what we do with the test. The problem, of course, is that this is not realistic. The trial would probably have to occur over decades and in a huge population to be mathematically powered to show differences between all the courses of action. Meanwhile, the technologies will have evolved tremendously, especially now as we enter the era of nanotechnology, gene therapy, AI, etc. So I don't think we're ever going to have such a trial, and even if we do, the results will arrive after the interventions have evolved.
Meanwhile, even randomized trials have tremendous limitations. For example, it's taken half a century to realize that all the trials about saturated fat accelerating heart disease may be wrong, or at least somewhat wrong. There are just too many variables affecting heart disease prevention, and so many things we don't yet understand, to think that somehow one more study can decide for an entire population how to manage their heart health. This is another reason individuals should be empowered to make their own decisions and not told a relatively low-cost test is too costly.
Risk of statins outweigh benefits