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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

#21

Post by Aurornis »

jrvarela56 wrote: post #17
Telemakhos wrote: post #11

Earlier quoted context omitted.

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.

There’s an offshoot of the keto community that has become die-hard cholesterol deniers. They don’t necessarily argue that keto doesn’t raise cholesterol. They argue that it doesn’t matter to have high cholesterol. They believe doctors and science are wrong on the subject. They think statins are evil. They embrace a few fringe doctors who agree with them.

If you do try keto again, bacon and such are the worst way to do it. Getting your fat content from a monounsaturated source like avocado oil can be helpful. Taking statins is also a good idea.

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

#22

Post by FollowingTheDao »

wrs wrote: post #16
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.

Manganese has been show to reverse plaques.

https://medicalxpress.com/news/2023-11-manganese-bullet-card...

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

#23

Post by Aurornis »

lawls wrote: post #7

I had a calcium score of zero, is that good? Hereditary high-cholesterol.

If you’re young: Good but doesn’t guarantee anything.

If you’re old: Great! Keep an eye on cholesterol.

CAC is a lagging indicator. Its usefulness is more about assessing damage done, not rate of change or future risk.

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

#24

Post by leereeves »

Aurornis wrote: post #20
leereeves wrote: post #10

Earlier quoted context omitted.

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 cumulativ…

I think the unknown factor here is whether other benefits of keto over a standard American diet--possibly including reduced inflammation, BP, blood glucose, and body weight--balance out the effect of cholesterol. CAC measures actual damage already done, while cholesterol is just one of many factors.

The downside, of course, is that once the damage is done, it's done, so it's a risk. (And as you said, they won't see the damage in their 20s.)

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

#25

Post by zzzeek »

This article is so anathema to me.

My experience is, your total cholesterol is over 200 (with some more specifics about LDL I can't recall, like 130 or something), all doctors everywhere will then hound you incessantly to get on Crestor, immediately. Diet and exercise don't matter (they cite research showing it doesn't make a difference). Whether you have plaque or not isn't considered, you need to be on Crestor right now to prevent it from starting anyway.

My cholesterol started really going up in my late 40s and I can concur an aggressive change to my diet where I significantly reduced my saturated fat intake and I lost about 20 pounds made absolutely no difference, and my total cholesterol started hitting 300, so I'm on the Crestor. My initial dose did cause me to have elevated liver enzymes and my total cholesterol went to about 170 in about a month, so I'm on an extremely low dose on alternating days.

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

#26

Post by crdioptnt »

The first sign of trouble was chest pains while playing tennis. The pain subsided after a couple of minutes and I was fine. EKG showed no sign of heart attack or major blockage. Prior to that I had no symptoms whatsoever, exercised regularly, never smoked, 57yo male, 6 ft, 175lbs. A CAC scan revealed a calcium score of 411 and a stress test indicated a major lack blood flow to the front of the heart. A cardiac catheterization revealed 95% blockage of the Left Anterior Descending artery, the widowmaker. After placing two stents in the LAD I’m back to normal. It’s a small miracle I didn’t die that day on the tennis court. The CAC definitively diagnosed the life threatening blockage when I had absolutely no symptoms. I recommend everyone get this simple scan to find out if you have this killer inside of you.

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

#27

Post by djoldman »

crdioptnt wrote: post #26

The first sign of trouble was chest pains while playing tennis. The pain subsided after a couple of minutes and I was fine. EKG showed no sign of heart attack or major blockage. Prior to that I had no symptoms whatsoever, exercised regularly, never smoked, 57yo male, 6 ft, 175lbs. A CAC scan revealed a calcium score of 411 and a stress test indicated a major lack blood flow to the front of the heart. A cardiac cathet…

What were your lipids? Was a stress test not conducted?

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

#29

Post by ars »

crdioptnt wrote: post #26

The first sign of trouble was chest pains while playing tennis. The pain subsided after a couple of minutes and I was fine. EKG showed no sign of heart attack or major blockage. Prior to that I had no symptoms whatsoever, exercised regularly, never smoked, 57yo male, 6 ft, 175lbs. A CAC scan revealed a calcium score of 411 and a stress test indicated a major lack blood flow to the front of the heart. A cardiac cathet…

> EKG showed no sign of heart attack

What about troponin? I was told by a Dr that it's more accurate than an EKG.

Edit: I had the word tryptophan before.

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

#30

Post by pugworthy »

ars wrote: post #29
crdioptnt wrote: post #26

The first sign of trouble was chest pains while playing tennis. The pain subsided after a couple of minutes and I was fine. EKG showed no sign of heart attack or major blockage. Prior to that I had no symptoms whatsoever, exercised regularly, never smoked, 57yo male, 6 ft, 175lbs. A CAC scan revealed a calcium score of 411 and a stress test indicated a major lack blood flow to the front of the heart. A cardiac cathet…

> EKG showed no sign of heart attack What about troponin? I was told by a Dr that it's more accurate than an EKG. Edit: I had the word tryptophan before.

Did you mean Troponin? Troponin shows up in the blood when there's been damage to heart muscle.
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