Zero CAC score = best predictor of No CVD

[Julie G]

Over 6800 participants from the MESA were followed for ten years correlating multiple risk factors with hard outcomes including CVD events. Not unexpectedly, a CAC score of zero provides the GREATEST downward shift in estimated CVD risk. The second best predictor was CIMT thickness followed by a CRP of <2 mg/L.

Role of Coronary Artery Calcium Score of Zero and Other Negative Risk Markers for Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA).
http://www.ncbi.nlm.nih.gov/pubmed/26801055

CONCLUSIONS: Negative results of atherosclerosis-imaging tests, particularly coronary artery calcium score of 0, resulted in the greatest downward shift in estimated CVD risk. These results may help guide discussions on the identification of individuals less likely to receive net benefit from lifelong preventive pharmacotherapy.

Interestingly, the authors suggest that the use of a CAC score may help with medical decision making- like whether or not to use statins. Given the relatively poor correlation between lipids and actual CVD, it might be reassuring (or motivating!) to learn your CAC score.

For anyone who's planning on going us in Boulder for our meet-up in August, George has arranged an opportunity for us to receive low radiation, low cost ($195-cash) EBT scans through Front Range Preventative Imaging. Email Lindsay at: heartscan@comcast.net to learn more and/or to make your appointment. She has blocked out August 10th for our group.

[Julie G]

Gulp... I made my an appt. for my husband & myself via email. It was simple. I'm slightly terrified of the results, but realize I should know to quantify my heart health. I (4/4) did a CIMT last May and no plaque was found, but I was in the 75%ile for my age group for thickness despite years of excellent lipids. My (2/3) husband, on the other hand, has years of awful lipids (both standard & advanced) and scored in the 25%ile. Go figure. Our unexpected & discordant results underscore the value of EBT testing.

[SusanJ]

On the other hand, my hubby (3/3) had his first one done at age 51, found 8 blockages (one in the widowmaker) and got very aggressive about treatment. I figure it saved his life.

I'll be there for you Aug 10.

[Julie G]

LOL, Suan. Be there for YOU.

Sobering story about your husband. Thanks for sharing. I agree; it probably saved his life- WOW.

[Tincup]

Another CAC thread with link to MP3's by a doc who scans: https://www.apoe4.info/forums/viewtopic ... hilit=scan
Repeat scans measuring progression are important. Especially with non-zero results. See the Raggi paper: https://www.apoe4.info/forums/viewtopic ... =10#p14817

Julie's paper - full: http://sci-hub.io/http://www.ncbi.nlm.n ... d/26801055

MESA risk calculator including CAC: https://www.mesa-nhlbi.org/MESACHDRisk/ ... Score.aspx

Our results with real data:
Wife

Screen Shot 2016-03-04 at 9.11.55 PM.png

Me

Screen Shot 2016-03-04 at 9.11.14 PM.png

Also, Julie has posted this before elsewhere - ApoB/ApoA1
Me: 96/143 = 0.67 sdLDL=30, Wife: 99/159 = 0.62 sdLDL=20


http://www.thefatemperor.com/blog/2016/ ... e-is-apoa1

All in all, not bad for a 3/4 and a 4/4 on a near vegan LCHF diet...

[KatieS]

According to a radiologist friend of mine, the carotid US might have a degree of subjectivity in interpreting the presence of minimal plaque. My US had the same CIMT measurements, but reversed right and left and had mild plaque about three years later. The US was read by two different radiologists. Upon direct comparison of the two scans by my request, there was no change.

So I think the computerized software in the CAC scoring (http://www.insideradiology.com.au/pages ... trr6cfw-Cc) greatly enhances reliable feedback on our lifestyle interventions. Thank you George for arranging this with Lindsay as a group day.

[SusanJ]

Just for grins, I reran the MESA 10-Year CHD calculator now that I have my CAC score from August.

Here's the results.

The estimated 10-year risk of a CHD event for a person with this risk factor profile including coronary calcium is 2.1%. The estimated 10-year risk of a CHD event for a person with this risk factor profile if we did not factor in their coronary calcium score would be 2.2%.

I have an Agatston score of 5.16 and one calcified spot noted from the scan. No surprises since my Dad's family has CHD in spades (including one of his sisters who had quadruple bypass, but still alive at 91!).

I did find it very interesting, and perhaps a clue into the calculator, that my risk is ever so slightly higher without factoring in the Agatston score. Wonder if they use some average what your score might be if you don't supply it based on age.

[slacker]

For anyone who's planning on going us in Boulder for our meet-up in August, George has arranged an opportunity for us to receive low radiation, low cost ($195-cash) EBT scans through Front Range Preventative Imaging. Email Lindsay at: heartscan@comcast.net to learn more and/or to make your appointment. She has blocked out August 10th for our group.

August 2017 meetup link not working? I'd like to know more so that I can attempt to plan in advance and possibly attend.

[SusanJ]

Slacker, the reference was from the 2016 meetup. We don't have the 2017 planned yet. Stay tuned.

[Robin2038]

On a closely related issue.. my husband just received a Cardiac calcium score if 0. I asked him to get the test because I was concerned about his cholesterol (triglycerides 350 HDL 45 and LDL 160). He's a pescatarian who enjoys rice and pasta and I believe he eats way too many carbs. He doesn't like to take medication and stopped taking statins after only a few weeks years ago due to muscle aches. He has been running consistently for over 30 years and has a resting heart rate in the 40s to 50s. His stress tests are always normal. He's 57. Should I leave him or nag him to see a cardiologist soon (he went to one I wasn't impressed with last year).
I've tried to talk him into eating less carbs but he isn't concerned. Would anyone worry with that profile and CAC score?
Happy holidays
Robin