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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

#71

Post by cluckindan »

Etheryte wrote: post #60
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.

https://www.nature.com/articles/s41467-020-19589-w

”we evaluated the full spectrum of nutrient intake and identified a significant positive correlation between ImP [imidazole propionate] and saturated fat intake (driven by high cheese intake)”

Perhaps this depends on the type of cheese consumed.

Of course, it’s a correlation; ImP could be modulating eating habits and making people prefer eating cheese.

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

#72

Post by ethan_smith »

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?

Plaque regression is possible through aggressive LDL lowering (statins+ezetimibe/PCSK9i), lifestyle changes, and has been documented in clinical trials like REVERSAL and ASTEROID showing 6-9% regression with intensive therapy.

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

#73

Post by Jarmsy »

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…

Don't statins calcify plaques? So presumably being on statins would raise the score?

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

#74

Post by potamic »

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…

When did you previously have a stress test before this? Would you also mind sharing what your blood pressure levels were at?

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

#75

Post by justlikereddit »

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…

>when I had absolutely no symptoms

Chest pain during excretion is a symptom in my book.

>Recommend everyone to get it

A calcium scan is a ECG gated CT scan(a heart CT). It takes time from the CT machine schedule and it requires radiologists to describe it, meaning it's not infinitely accessible.

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

#76

Post by justlikereddit »

andy_ppp wrote: post #67
agumonkey wrote: post #66

Earlier quoted context omitted.

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?

"It should be very easy for an AI to look at an x-ray, CT, ultrasound or MRI image and tell what disease a human got, even some that humans don't know of.

Are there any labeled datasets "

-Some Software dude, every month since 1971

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

#77

Post by _zagj »

coldcode wrote: post #13
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.

> My cardiologist did all of these except the eGFR

eGFR is typically inferred from serum creatinine (not creatine!), which is part of both a comprehensive and basic metabolic panel (CMP/BMP), which your GP usually orders, along with a CBC, and perhaps an HbA1c.

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

#78

Post by _zagj »

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.

Oddly enough, there's evidence that saturated fat intake inversely affects Lp(a) levels: https://pmc.ncbi.nlm.nih.gov/articles/PMC10447465/

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

#79

Post by justlikereddit »

Mistletoe wrote: post #70
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.

How do you get one and what is the cost?

A CAC scan is a non-contrast CT scan and a coronary angiography is a contrast CT scan.

They are both ECG gated scans of the heart otherwise so they're pretty much the same scan area and same scan duration, if you're hooked for a Coronary CT angiography you can easily get the CAC at the same time by doing a scan sweep before contrast administration (at the cost of 2 minutes of time and an extra dose of radiation)

Though the logistics surrounding contrast administration makes it a bit more fiddly with a slightly higher risk profile.

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

#80

Post by agumonkey »

andy_ppp wrote: post #67
agumonkey wrote: post #66

Earlier quoted context omitted.

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?

I wonder if all symptoms would show on an EKG though. Would reduced coronary blood flow alter electrical signals ?
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