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Coronary artery calcium testing can reveal plaque in arteries, but is underused

nytimes.com

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Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#11

Post by Telemakhos »

Aurornis wrote: post #6

This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine. These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that…

Is this a keto diet that's mainly leafy greens with healthy protein like salmon? Or is this the "keto" diet of bacon and steak and as much fast as one can shove in the food-hole?

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#13

Post by coldcode »

brandonb wrote: post #3

Before getting a CAC scan, I'd probably do these tests first: * ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease. * Lp(a) - the strongest hereditary risk factor for heart disease. * hs-CRP - inflammation roughly doubles your risk of heart disease * HbA1c - insulin resistance is a risk factor for just about everything. * eGFR - estimates the volume of…

My cardiologist did all of these except the eGFR. My calcium score was fairly high, but not high enough to be concerning since my cholesterol is controlled and my diet and exercise regime are good now. Until the CAC was done, I had no idea if I had any or not. It's better to deal with cholesterol earlier than I did.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#14

Post by wrs »

My cardiologist pointed out that hard calcified plaques are unlikely to come loose, so unless there’s significant narrowing, they’re not a big problem. However, that situation correlates with a high calcium score. So the calcium score is not always correlated to risk.

A CT angiogram distinguishes soft vs. hard plaques (and shows narrowing), so that’s the ultimate way to clarify the situation. (Bearing in mind radiation exposure risk and cost, of course.)

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#15

Post by anonzzzies »

DiabloD3 wrote: post #12
klipklop wrote: post #9

What I always wondered is if I get this test done, what would I even do with the results? If my arteries are already clogged, etc. Can this plaque be reversed?

Yes.

... more info please..

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#16

Post by wrs »

klipklop wrote: post #9

What I always wondered is if I get this test done, what would I even do with the results? If my arteries are already clogged, etc. Can this plaque be reversed?

Normally yes, through some combination of diet, exercise, statins, and the new kid on the block, PCSK9 inhibitors.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#17

Post by jrvarela56 »

Telemakhos wrote: post #11
Aurornis wrote: post #6

This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine. These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that…

Is this a keto diet that's mainly leafy greens with healthy protein like salmon? Or is this the "keto" diet of bacon and steak and as much fast as one can shove in the food-hole?

I don’t understand why some prople claim that diet does not impact cholesterol. I did ‘keto’ with bacon/steak/chicken/etc for 3 months, got bloodwork done before and after and my LDL went through the roof.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#18

Post by anonzzzies »

wrs wrote: post #14

My cardiologist pointed out that hard calcified plaques are unlikely to come loose, so unless there’s significant narrowing, they’re not a big problem. However, that situation correlates with a high calcium score. So the calcium score is not always correlated to risk. A CT angiogram distinguishes soft vs. hard plaques (and shows narrowing), so that’s the ultimate way to clarify the situation. (Bearing in mind radiati…

It is free where I am but the radiation is a problem: maybe every 5 years is OK?

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#19

Post by Aurornis »

Telemakhos wrote: post #11
Aurornis wrote: post #6

This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine. These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that…

Is this a keto diet that's mainly leafy greens with healthy protein like salmon? Or is this the "keto" diet of bacon and steak and as much fast as one can shove in the food-hole?

> keto diet that's mainly leafy greens with healthy protein like salmon?

A ketogenic diet is 70% fat.

It’s literally impossible to get into keto with a diet of leafy greens and salmon. You would have to augment with a lot of fat from some other source and also limit salmon intake to avoid consuming too much protein. Salmon has too much protein and not enough fat to even come close to keto ratios.

You must be thinking of a different diet. A lot of people think keto is another word for low carb, but a real keto diet is very low carb and low protein.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#20

Post by Aurornis »

leereeves wrote: post #10
Aurornis wrote: post #6

This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine. These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that…

I agree the results after one year of a keto diet don't prove much, but getting that test seems like a good idea. I hope they'll keep testing and reporting the results for years, so we can learn more about the long term effects of a keto diet. And if it does cause problems, they'll want to know ASAP.

CAC tests come with a non-trivial radiation exposure if someone is getting them every few years.

The other problem is that they’re picking and choosing which tests to believe and which to ignore.

They disregard their cholesterol tests because they don’t like the results, but embrace one or two CAC tests because they do like the results (when they’re young).

However the CAC results are a lagging indicator of cumulative damage that has been done. Cholesterol tests are correlated with the rate of damage occurring.

So embracing CAC and using it to justify ignoring LDL and others is the problem.

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