EBT Calcium Scan

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: EBT Calcium Scan

Post by Julie G »

Great question, Chris. I hope somebody chimes in with a one stop answer. For now we have a range of piecemeal options to access our level of CAD risk. Those with lower risks like lipids, advanced lipids, glycemic & inflammation markers, etc. are only surrogate markers with spotty correlation while higher risk options like a CT scan & angiogram carry much more risk but provide more definitive information. A CIMT and EBT fall smack dab in the middle of that range. It ends up being a risk/benefit issue. Tricky.
User avatar
ru442
Contributor
Contributor
Posts: 706
Joined: Sun Mar 20, 2016 8:52 am

Re: EBT Calcium Scan

Post by ru442 »

I'm not sure about middle earth or over the pond, but my GP in the US usually starts with a CORUS CAD test first to evaluate risk. It's a blood draw, and you get a ranking based on the screening, some info from the website:

Corus CAD is a blood test that:

* Integrates your age, sex, and gene expression to calculate a score. The higher the score, the higher the likelihood of having a significant narrowing or blockage in your heart arteries.
* Takes into account cardiovascular differences between men and women in its assessment.
* Has been validated in two clinical studies in the U.S. called PREDICT and COMPASS, with 526 and 431 patient samples, respectively.1,2
* Provides your doctor with a score indicating the likelihood that you have a significant narrowing or blockage in your heart arteries.
* Is simple to administer, safe, and convenient, requiring only a routine blood draw procedure.

Website: http://www.cardiodx.com/

My first one scored a 23 about 3 years ago, went to cardiologist and did a nuclear stress test and was all clear. My last one was March when I found out my APOE status.... was 26. But then I made diet changes and both my cardiologist and lipidologist think this may be a false positive??

In any case, another 2 cents from RU442.....
Male 4/4 56 yrs., "Live, Laugh, Love"
User avatar
Tincup
Mod
Mod
Posts: 3558
Joined: Fri Aug 08, 2014 2:57 pm
Location: Front Range, CO

Re: EBT Calcium Scan

Post by Tincup »

At the Low Carb Breckenridge conference this weekend, Dr. Mike Eades mentioned a paper where you can compute density from Agatston CAC and volume scores from a calcium scan. For those with higher CAC scores, the density adjustment can portend lower risk for those with high density. So you'd look at your risk from your CAC score and then adjust down if your density was high.

Here is my post to the conference FB group:

The calculation: Agatston score/(volume/slice thickness in mm) = average density where Slice thickness was 3mm using the electron-beam CT scanners and 2.5 mm using the multidetector CT scanners. (I think the EBT scanner used at our Boulder meetup should use 3mm - I've emailed them to ask)

The hazard ratio ranges from 1 for quartile 1 to around .5 for quartile 4. Here’s the figure What you notice looking at Table 2 is that the subjects in Quartile 1 have low Agatson and volume scores (but volume scores are larger than Agatson, hence lower density). Here are the data: Median (25%-75% range) Agatson score for density was 8.9 (3.9-24.2) for quartile 1, 89.2 (32.0-221.8) for quartile 2, 214.4 (73.0-551.6) for quartile 3, 215.7 (80.8-558.4) for quartile 4, and 88.0 (21.8-298.8) for all participants. Median (25%-75% range) volume score for density was 14.0 (7.0-33.3) for quartile 1, 90.5 (34.9-224.3) for quartile 2, 194.5 (67.8-488.9) for quartile 3, 183.0 (68.7-470.4) for quartile 4, and 85.2 (24.5-273.4) for all participants. So the subjects in Quartile 1 are not likely to benefit from a high density risk reduction, however they have low risk anyway. It is subjects with higher scores who will benefit if they have higher density. The full paper paper.


FB discussion thread

In the thread, Ivor Cummins mentions the man who financed the "Widowmaker" movie, who has a high CAC score, saw his volume plummet while his CAC score increased slightly. Hence he ended up with a density of 8! The highest density mentioned in the paper was around 4. So the interpretation is that his risk is dramatically reduced. Here is what Ivor posted: Image
Tincup
E3,E4
Nequals1Guy
Contributor
Contributor
Posts: 56
Joined: Tue Jun 21, 2016 6:30 am

Re: EBT Calcium Scan

Post by Nequals1Guy »

So, I recently had a test for lp(a). It was 300! My ldl-p usually fluctuates around 1500~2000 depending on what I'm eating. Recently my particles lowered a bit by eating pescatarian and cutting most sat fats. I'm 46yom. I had a Calcium score =0 two years ago. In light of these base facts; 1) would a statin be advisable 2) should i up my life insurance policy because I'm a ticking time bomb? 3) I have not watched the video but I am assuming the EBT scan is different than the scan I had where I laid in a round machine. I'm not sure what that was called, a CT scan? The hospital in my town does them as a walk in service for $99. I'm good friends with the radiologist so he let me come back and review his findings. He was quick to note that the my 0 score is misleading because they can't really see much, it's mostly averages and measurements. The real killer is what's in the walls of the arteries and that is somewhat difficult to detect. I know I'm misquoting my friend terribly. I pretty much stopped listening when he said my score was 0.


Sent from my iPhone using Tapatalk
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: EBT Calcium Scan

Post by Julie G »

N=1, Lp(a) is measured in different ways. Was yours mg/dl?
User avatar
Tincup
Mod
Mod
Posts: 3558
Joined: Fri Aug 08, 2014 2:57 pm
Location: Front Range, CO

Re: EBT Calcium Scan

Post by Tincup »

Nequals1Guy wrote: I'm 46yom. I had a Calcium score =0 two years ago. In light of these base facts; 1) would a statin be advisable 2) should i up my life insurance policy because I'm a ticking time bomb? 3) I have not watched the video but I am assuming the EBT scan is different than the scan I had where I laid in a round machine. I'm not sure what that was called, a CT scan? The hospital in my town does them as a walk in service for $99. I'm good friends with the radiologist so he let me come back and review his findings. He was quick to note that the my 0 score is misleading because they can't really see much, it's mostly averages and measurements. The real killer is what's in the walls of the arteries and that is somewhat difficult to detect. I know I'm misquoting my friend terribly. I pretty much stopped listening when he said my score was 0.
My understanding is the EBT scanners are very fast - imaging the beating heart, but lower resolution. The newer CT scanners are higher resolution, and they use ECG to time the image when the heart is not beating. So both are OK.

As these scans "see" calcium, they don't see soft plaque, and soft plaque rupture is THE problem. So even a zero score is not zero risk. However it is very low risk for a zero score. Soft plaque will calcify over time, hence if you have been/are making a lot of soft plaque and have been doing that for a while, it should show up in your calcium score. For those who have a non-zero score, the Raggi paper showed a dramatic reduction (like 17 times) in risk if the annual increase in volume score was less than 15%. The assumption is that the small increase is due to calcification of existing soft plaque, and this is OK. The increase in density described in my link above is getting at the same point.

It is generally considered you have a 4 or 5 year "warranty" if you have a zero score.
Tincup
E3,E4
Nequals1Guy
Contributor
Contributor
Posts: 56
Joined: Tue Jun 21, 2016 6:30 am

Re: EBT Calcium Scan

Post by Nequals1Guy »

Juliegee wrote:N=1, Lp(a) is measured in different ways. Was yours mg/dl?
This was a test done by True Health Diagnostics. Their optimal range says anything under 75. High risk is anything >125. Mine is 301 (nmol/L)




Sent from my iPhone using Tapatalk
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: EBT Calcium Scan

Post by Julie G »

Thanks, N=1. That helps. Your numbers are definitely out of range. Try using our search engine. We've had multiple threads devoted to the subject. Other members are struggling with this confounder as well. Dr. Dayspring suggests in this link that Lp(a) is only detrimental in the presence of LDL-C >160. Controlling hypercholesterolemia, along with other risk factors, may be more important for you. The good news: elevated Lp(a) is also associated with longevity. I hope others dealing with this chime in with more current evidence.
User avatar
Tincup
Mod
Mod
Posts: 3558
Joined: Fri Aug 08, 2014 2:57 pm
Location: Front Range, CO

Re: EBT Calcium Scan

Post by Tincup »

Nequals1Guy wrote:
Juliegee wrote:N=1, Lp(a) is measured in different ways. Was yours mg/dl?
This was a test done by True Health Diagnostics. Their optimal range says anything under 75. High risk is anything >125. Mine is 301 (nmol/L)
Dr. Gundry treats lp(a) with his diet plus niacin. I have mild elevation and modest amounts of niacin, either as niacinimide or plain niacin (Slo Niacin) will lower it. In this paper he adds 150 mg CoQ10/day. "Results: Patient ages ranged from 45 to 78 yrs. Baseline Lp(a) ranged from 33 to 168 (mean 78mg/dL) and fell to 10 to 45 (mean 28mg/dL) in 6 months with the diet and supplement program."

He likes us (as E4's) to take the niacinimide form as he's citied rodent studies suggesting a positive brain effect.

From his first book:
About 25 percent of us carry a gene that codes for the manufacture of a particularly small, deadly type of cholesterol known as lipoprotein(a), or Lp(a). Many doctors haven’t heard of what I call “bad cholesterol with an attitude,” and even if he or she has, your doctor has been taught that neither statin drugs nor dietary changes have any effect on it and therefore they don’t bother testing you for it. If your ancestors hail from northern Europe or the British Isles, there’s a good chance you carry the gene. The harsh climate in northern Europe meant that the diet was often deficient in vitamin C, predisposing the population to scurvy. Vitamin C is essential to reweave the broken bits of collagen that routinely occur inside our blood vessels—and our skin. Victims of scurvy often bleed to death from their gums or intestines. Enter Lp(a), which “spackles” holes in damaged blood vessels, allowing our northern European forbears to survive scurvy and reproduce, ensuring the ongoing life of their genes. So far so good. But Lp(a) is such a good spackling compound that it just keeps piling on any damaged area, which means that people with Lp(a) usually develop severe premature coronary artery disease. Why has this gene persisted if it’s so lethal? By now you should know. Individuals who carried the gene in vitamin C-sparse areas were able to patch up their leaky blood vessels, enabling them to live long enough to reproduce. Once these individuals had replaced themselves, their genes couldn’t care less if they die of a heart attack. My advice? Get your Lp(a) level measured with a simple blood test. Unlike what your doctor will probably tell you, my research, as reported in the journal Atherosclerosis, has shown that Diet Evolution and two simple supplements, CoQ10 and niacin, also known as vitamin B3, will lower Lp(a) to normal levels in the vast majority of people. You can turn off the genes producing Lp(a).

Gundry, Dr. Steven R. (2008-03-11). Dr. Gundry's Diet Evolution: Turn Off the Genes That Are Killing You--And Your Waistline--And Drop the Weight for Good (Kindle Locations 2033-2047). Potter/TenSpeed/Harmony. Kindle Edition.
Tincup
E3,E4
User avatar
KatieS
Senior Contributor
Senior Contributor
Posts: 1224
Joined: Wed Mar 05, 2014 1:45 pm

Re: EBT Calcium Scan

Post by KatieS »

Neq, I was devastated with a lp(a) hovering repeatedly around 200, with the exception of one measurement of less than 10 (?). Any chance you have a super high HDL? Recently they found that extremely high HDLs seem to interfere with the mice lp(a) measurements. Now I'm hoping that my HDL of 112 is creating this lab abnormality. My 99 y/o 3/4 mom( who has been interviewed again by Stanford this week), has the same high HDL & lp(a). There are so many phenotypes of lp(a), possibly see if other healthy family members are affected.

Only rosuvastatin is linked to slight lp(a) reductions, but it did not alter my measurements. Newer drugs to lower lp(a) are in the pipeline, but I would first discuss with your doctor if your lp(a) is truly pathological. However, I don't think we know the risks of the various phenotypes so I'm continuing on pravastatin 10mg (low-dose hydrophilic, but as a white male in the Medicare study favored the other statins for minimal dementia decrease).

You might consider a carotid ultrasound to check for soft plaque, if you have a family history of stokes/early CVD. Since I have the latter & am 64, I have "mild" non-changing plaque on my left carotid, but the IMT measurements are stable at 0.6.

Interestingly, I have found that decreasing my IR decreases my B/P, so this is a focus to not be overlooked.
Post Reply