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

nytimes.com

61–70 of 197 posts

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

#61

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.

Have you seen/read cholesterol code? It doesn't deny cholesterol but rather has interesting, and unusual findings.

https://cholesterolcode.com/

There’s a good talk as well that presents this information in a very accessible way:

https://youtu.be/jZu52duIqno?si=NCEf4UGtgHG9sBOP

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

#62

Earlier quoted context omitted.

... more info please..

So, the simple explanation is this: Cholesterol is a necessary and important chemical, specifically, it is a sterol, and a precursor for Vitamin D, cortisol, estrogen, testosterone, and the substance that makes up the myelin sheath is. Cholesterol is not, and never will be, "the bad guy". Your body produces almost a gram of it a day, but dietary amounts are only about a third of that. It it also the backbone of apoli…

Since you appear to be quite knowledgeable on the matter, I wonder what’s your opinion on Cholesterol Code and Dave Feldman? Thank you.

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

#63
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…

Anyone know of an equivalent in Europe? Dutch doctors always ignore me and say to come back after I’m dead. (But will happily tell me to take Tylenol)

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

#64

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...

Setting aside the fact that the majority of people prescribed them tolerate statins with minimal side effects, there are other therapies besides statins available for treating dyslipidemia such as PCSK9 and ANGPTL3 inhibitors, to say nothing of non-pharmaceutical lifestyle interventions one can make.

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

#65
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…

Yeah. Dr. Ford Brewer(https://www.youtube.com/@PrevMedHealth) talks a lot about this. I find him to be pretty current and he translates things into an easily understood format.

Basically the calcium stabilizes the plaque. Unstabilized plaque is what can rupture, squirting out from the artery wall into the blood and forming a clot. High cholesterol can cause deposits in the artery wall simply due to chemical diffusion. Inflammation, often caused by metabolic syndrome/diabetes expands the plaques. Idk, I probably got that wrong, but anyway calcium scores aren't well correlated with risk.

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

#66

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…

I wish cardiovascular monitoring was better. It's not uncommon for cardiologist to discharge you saying 'all fine, EKG ok' even though reality says otherwise.

Happy you got stents at the right time.

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

#67

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…

I wish cardiovascular monitoring was better. It's not uncommon for cardiologist to discharge you saying 'all fine, EKG ok' even though reality says otherwise. Happy you got stents at the right time.

EKGs should be extremely easy for AI to identify every disease with a range of probabilities and even some humans can’t identify from EKGs. Do we have the labelled dataset for this?

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

#68
post #31

Earlier quoted context omitted.

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

Yes I meant that! I spelled it wrong on Google, then copy/pasted the wrong word from the suggested replacement.

It’s only if heart muscle dies does that show up, you can have an important artery narrow without symptoms until suddenly a bit of plaque breaks off completely blocking a path causing bits of muscle to actually die.

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

#69
post #48

can attest that this test is worth it. despite having no symptoms i decided to take at 32 yo it since I have a family history of cardio problems. altho no calcified plaque was found, it uncovered other serious issues I wouldn't have know about otherwise for probably a decade or two. if you call around different radiology labs you can get it for as low as $200 -- be warned tho many places (esp hospitals in my exp) wil…

Places around me do it even cheaper. $50.

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

#70

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.

How do you get one and what is the cost?
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