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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

#51

Post by throwaway7783 »

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…

Calcium score is mostly for trends over a period of time, to get a sense of progression of disease. A single reading is not very useful is what I was told

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

#52

Post by rsanek »

breadwinner wrote: post #42

The point of this test is to decide whether to take statins. But statins are a problematic drug, see here: https://medium.com/@petilon/cholesterol-and-statins-e7d9d8ee...

not sure I'm gonna trust a medium article that lists NYT and Bloomberg as references over what basically every single cardiologist recommends

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

#53

Post by rsanek »

anonzzzies wrote: post #18
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?

yeah generally CT scan has crazy amount of radiation. want to probably switch to another test (like an echocardiogram) for long term monitoring

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

#54

Post by rsanek »

lazyasciiart wrote: post #41

After I had a heart attack I was told that there’s no value in doing this test at that point. A couple years later at age 40 another doctor did order it for me and my score was 0, which apparently tells me I’m not on the verge of another heart attack, so that’s nice.

the score itself isn't the only relevant thing in the report. ask to see what the radiologist actually wrote and read it yourself. ai, aided by clarifications by a cardiologist, helped me understand the details immensely

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

#55

Post by throwaway7783 »

OutOfHere wrote: post #43
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…

Unfortunately there is no approved oral medicine to lower Lp(a) that I am aware of. (I mean given a normal LDL.) Statins don't lower it afaik. An oral medicine named muvalaplin is being tested for it.

There are some in trials. I'm part of one by Eli Lily. Lp(a) sucks, is genetic and so far there was no medication.

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

#56

Post by rsanek »

lawls wrote: post #7

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

hard to say. the score itself is just a small part of what is included in the report. ask to see the full one to see what all the radiologist found.

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

#57

Post by rsanek »

IAmGraydon wrote: post #46

CAC is pretty common, but I prefer Coronary CT Angiography, which is much more detailed CT of the heart and coronary arteries using IV contrast. It's a bit more radiation, but it shows soft plaque and arterial narrowing, which CAC does not.

seeing soft plaque is critical, as is the structure of vessels such as the aorta. highly recommend getting the more expensive test.

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

#58

Post by rsanek »

jgalt212 wrote: post #8

These tests expose one to a fairly high dose of radiation. From a quick googling, there does seem quite a range in exposures for this test. That being said, you probably don't want to get one of these scan every year.

my doc recommended doing alternative tests to monitor instead (eg echocardiogram)

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

#59

Post by cluckindan »

Researchers have discovered that gut bacteria produce a molecule that not only induces but also causes atherosclerosis, the accumulation of fat and cholesterol in the arteries that can lead to heart attacks and strokes.

https://english.elpais.com/health/2025-07-17/revolution-in-m...

Apparently eating too much cheese is a large risk factor.

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

#60

Post by Etheryte »

cluckindan wrote: post #59

Researchers have discovered that gut bacteria produce a molecule that not only induces but also causes atherosclerosis, the accumulation of fat and cholesterol in the arteries that can lead to heart attacks and strokes. https://english.elpais.com/health/2025-07-17/revolution-in-m... Apparently eating too much cheese is a large risk factor.

I'm not sure quip generalizations like that are useful. If it was as simple as cheese bad, we would see the dutch and the like as outliers in statistics, but that's not the case.
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