5 Myths about the Coronary Calcium Score (CAC) | Tom Dayspring, MD
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- Опубліковано 15 чер 2024
- The Coronary Calcium Score can be useful, but several myths surround it. We cover 5 misconceptions regarding the calcium score and how to interpret a calcium score to lower our heart disease risk.
Let’s talk calcium scan or calcium score. The calcium scan shows calcification in coronary arteries
myth: “CAC score of 0 means no plaque”
a CAC score of 0 doesnt mean no plaque
CAC doesnt measure plaque. Measures calcification. Calcification happens late in plaque formation process.
you can have a CAC of 0 and have soft plaque. Non calcified.
study: people with lots of plaque, 14% had CAC of zero. most young people with obstructive CAD had a CAC of zero
“diagnostic value of a CAC score of 0 small in the young"
advanced coronary disease: ~30% of heart attacks or death in people with CAC of zero
if CAC is zero odds are low you have obstructive CAD. but doesnt rule it out
even with a lot of plaque, calcification may not have developed
CAC =0 is good news, it’s a marker of lower risk, but it doesn´t mean immunity
we can have plaque in other places besides coronaries
CAC=0: 54% had plaque in the legs or the carotids
CAC of zero is desirable, but far from perfect
CAC=marker of advanced disease. CAC=0 may mean no plaque. or maybe there is. CAC doesnt rule that out
CAC=0 doesnt mean zero calcification. just detectable calcification
scan picks up calcification above certain size, not small calcium spots. ~4% with CAC=0 had calcification
myth: CAC=0 means zero risk
"LDLc or apoB is high but CAC=0 so I´m safe"
“score of zero does not imply risk is zero (heart attack, stroke etc) or zero atherosclerosis (plaque)”
“CAC of zero may provide false sense of security”
CAC of zero indicates low 5-10y risk
value of CAC score depends on age
CAC=0 is the norm in young
“CAC of zero in the young is normal, more power at older age. value of a CAC of zero increases with age”
myth: "if CAC goes up, i´ll make changes"
calcification=advanced plaque
real power is in preventing plaque
“Plaque calcification is a late event, not for pre-plaque detection (goal = prevent plaque)”
some methods measure soft plaque. angiography.
calcium not the cause of risk. marker of risk
The more plaque, the more likely there’s calcification. calcification isn’t the problem. Calcification is part of the scarring of the artery, can make artery less likely to rupture
“plaque disruption and thrombosis not in calcified segments; calcium not the cause”
in general more calcium means higher risk, it´s a marker of more plaque and more advanced plaque, but something could increase calcium and not raise risk
statins can increase CAC but risk goes down. statins stabilize plaque, including calcification
CAC can refine risk. young with CAC that is NOT zero; older with a score of zero; borderline case with some risk factors but not clear if statin is appropriate, CAC can help decide
Connect with me:
Facebook: / drgilcarvalho
Twitter: / nutritionmades3
Animations: Even Topland @toplandmedia
References:
1-One page primer: jamanetwork.com/journals/jama...
2-obstructive CAD: jamanetwork.com/journals/jama...
3-plaque in other territories even with CAC=0
www.ahajournals.org/doi/full/...
4-calcification even with CAC=0
europepmc.org/articles/pmc961...
www.atherosclerosis-journal.c...
5-CAC=0 desirable but imperfect
www.ahajournals.org/doi/epub/...
6-low 10y risk with CAC=0
www.sciencedirect.com/science...
7-prevalence of CAC=0
jamanetwork.com/journals/jama...
8-calcium is not the cause: www.jacc.org/doi/10.1016/j.ja...
9-Statins & calcium
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 What is the calcium score?
0:53 Plaque with CAC=0
3:53 Calcification with CAC=0
4:32 CAC=0 and Risk
8:01 Calcium score and Age
9:33 Window of opportunity
10:47 More sensitive tests
12:17 Calcium is not the cause
13:32 Statins and Calcium
15:25 Take-aways and strategy
16:50 Additional Resources
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 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!
This is absolutely the best lucid explanation I have seen on UA-cam!
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:)
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 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. UA-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 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.
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?
Awesome video as always.. Great work doc!! 👌👌
Excellent analysis and explanations...thanks.
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.
Great video! Is there a way to reduce your calcium (score) if it is already higher than your age group? K2?
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
this videos are so SOBER!!! thank you!
Learning new stuff all the time with you, thx!!
Great information on value of calcium score ...lots of thanks from Chennai India
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
Great info, thanks! Always enjoy your videos.
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.
Ldl alone isn't a concern, dawg.
Thanks for the excellent explanation.
You are doing a great service with your videos. Keep it up :)
Excellent video. Thank you so very much.
Thank you. Very informative as usual.
Fantastic explanation! Thank you!
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!
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?
Thank you 🙏🏻 such a precious and clear info!! Bless you 🤍
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.
I'm removing mine and without statins help. 660 to 458 so far!
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
Yeah, like vitamin C deficiency for me. The plaque may be hard and stabilize, but I don't consider it a good thing. It's still narrowed. The damage is covered up by calcium instead of repaired correctly with collegen made by vitamin C.
Dr. Thomas Levy Cardiologist "Stop America's # 1 Killer" Proof that the Origin of All Coronary Heart Disease is Clearly Reversible Arterial Scurvy.
67 year old male CT scan 660 now 458. No Statins.
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?
Excellent video with very important/relevant- information for people worried(or interested) about cardiac health and how to gauge it correctly! 👍👍👍
So many "youtube doctors" are spreading mis-information on this topic, that it makes me sad....glad to see you don't seem to fall into that group of people! 😉👍
Look at all cause mortality. That is not affected by high cholesterol in people on low carb diets and in many cases falls as cholesterol goes up. Go figure.
Excellent video. Very informative. 👍🏽💯🔥✔
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
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!
Thank you for great information!
Wish I could like this multiple times!
Preposterously informative
Great talk much appreciated
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.
Thank you for a great explanation!
Very educational. Thank you.
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!
Hi Dr Gil,
What is the optimal number of Apo B and Apo A1?? Thanks as always
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?
Thanks so much for this informative video!
I’m 27 and I’ve had episodes of palpitations and left arm, left shoulder and back pain. My ECG, 2D echocardiogram and treadmill ECG were fine. Would I benefit from a CAC test? I want to get CTA done but my cardiologist says I’m too young for it. My ApoB is 90.
thanks so much for this explanation
Thanks, very informative video!!
Do you have a video on when/if to stent?
Can we have some episodes for exercise, weight lifting, HIIT,cardio...for optimal health, what's best exercise type for what situation and similar... ?
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!
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!!
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.
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.
This a really good explanation of CAC
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.
Tysm for the detailed info abt clogged arteries test vac that o knew ZERO abt. My cardiologist last week explained little to none what a score 105 meant for my 138 lb 78 yr old meant …this helped so much !
Hey Gill, big fan of the channel and your clear and concise information. As a reasonably fit guy in my early 40s i just found out i have FH-and a correspondingly high ApoB. However my ApoA-1 is also high. I've seen studies suggesting that ApoB/A1 ratio should be used for future CHD risk, so do you think having a high ApoA-1 offsets a higher ApoB in any way??
the strongest evidence points to ApoA-1 being a marker of other risk factors but not protective per se (similar to HDL-C). They don't offset risk per se. There is substantial heterogeneity in FH depending on type of mutation involved. Medication is indicated, and I imagine your other family members are also looking into their own status? With proper management the prognosis is much better now than a generation ago
Exactly my question..and that answer was not as strong..
APO A is an HDL component of APO.. so the ratio is important!
also the oxidized LDL particle test is crucial..
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?
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 ?
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.
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?
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
I had a calcium score of zero and a heart age of 39. My arteries were clear and I am super healthy and workout strenuously. I was 70 when I had the scan. My heart is strong. I am strong and fit and healthy. There are no guarantees in life but I know my body and how it functions. I am very slim and muscled. Bye.
Hopefully you’ll have a podcast with Dr. Ford Brewer.. great discussion
I absolutely agree!
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?
Another valuable vid.
What about a CIMT test to detect soft plaque?
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?
@@NutritionMadeSimplestatins do mot lower risk. They increase it.
Another great video. Clear and useful information. Thank you!
thank you. I needed this
Excellent video
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?!
Excellent video! One question I have is, what is the implication of say a CAC score of 30? Or near but under 100? I don't see much info on how to interpret scores that are above 0.
Any NON Zero CAC is a huge risk. Start ur statin NOW.
It's all about your age. If your 40 30-100 is bad news. If your 70 it's not as bad. The score is compounding meaning it can double in 5 years. I'm 68 I started with 299 at 60, then 660 at 65. I started Linus Paulings Heart Protocol and 20 months later had a score of 458.
If you go onn a statin you can look forward to the score climbing in the name of stabilization of soft plague. But I prefer it all gone. Which you can see is decreasing rapidly. Though most cardiologists will say it's not possible.
The choice is yours!
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.
Great work👍👍👍👍
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
Hope you get this. What is the link to the one page primer?
So can a CT scan not image soft plaque? Is there not a soft plaque score? It seems kinda important.
Thank You!
I'm a 65 y/o female. My calcium score is 19. Left main is 0, right coronary artery is 0 and the left anterior descending 19, circumflex 0, posterior descending artery 0. I have a pretty significant family history of heart disease. My bp is well controlled on my medication. Is there anything that I need to be doing to reduce my chances of a MI?
Fantastic video
Thank you for the video. Is calcification is reversible? May be another video?
It's been for me! CAC of 660 to 458.
@@SET12DSPhow?
❤how did you do it?
K2 & D3
Excellent!!!!
I'm 58 and had just had a CAC score of 82. I have tried statins, but the side effects complicated an autoimmune disease (Reactive Arthritis) that I'm also receiving treatment for. I've been on Repatha for about 4 months now and tolerate it much better. My cardiologist says that if we had Repatha 25 years ago, we would have half as many people dying from heart disease. My question is does Repatha also stabilize Calcium like a statin?
These guys are the best ..
I can't believe you don't even take donations you put out such high quality information
Very clear thank you
Very interesting - thanks
Any comments on vitamin K2 and calcium buildup.
Excellent!
Thank you
My cac test several years ago: zero. Late 60's age. Apo b low range. Finally with help good Lord got my Lpa low acceptable range. Later I was diagnosed with DVTs and take warfarin. How best to manage or prevent calcification?What better test are available other than the invasive one mentioned?
Thanks
@@NaturalHeartDoctor appreciate much!
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!
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: ua-cam.com/video/1HDfzA7eIqQ/v-deo.html
I am curious why doctors in the US aren't ordering the Calcification Scan on their patients. Once it's been established that a patient has calcified plaque, what can be done about it? Especially if that patient has been on the conventional treatments: ie Statins, dietary mods etc.
Sir, I have Calcium score is 4.1
LAD Type III
As per Cardiologist I have Minor CAD.
I am taking regularly Atorvastatin, Clopetogrel, Telmesartan etc.
Am I in Danger zone?
Advice me.
Am I in danger
My age is 65 years
I have RBBB
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.
Would like to know why I can't get a CAC when I have Stents?