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Old 08-06-2019, 01:29 PM   #21
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This may give some reassurance to those reading this thread.

First, I'm a high total cholesterol person. It has been up around 300 all my life.
That's OK with me because I have nice low triglycerides and high HDL so my ratios are excellent.

Second, I had a fairly high calcium score about ten years ago, with the total up close to 400. I took some comfort in the doc's comment that there was no way to tell how long it had been there, and might be leftover from early in my life with no current calcification. Wishful thinking perhaps, so I'm planning to get another one to find out.

Since I'm opposed to statins for various reasons, my new doc made a deal with me. He would get off my case if I agreed to three tests, and I had them this year. First, a AAA (abdominal aorta aneurysm) ultrasound, second a carotid ultrasound, and third a stress echocardiogram.

Passed all three with flying colors, so the doc agreed I'm OK living the way I do. Of course, I'm not in a high risk group otherwise. No history of heart attacks in my family, I'm not a smoker or overweight, and I get plenty of exercise.

On the subject of calcium scores, I think it's worthwhile to recognize that it's only one test. There was a study in the New England Journal of Medicine that looked at nearly 7,000 people over four years and divided them into groups. For simplification, I'll choose two, those with scores from 1 to 100 and those with scores over 300. The higher scoring group had around three times the relative risk of the low scoring group, but look at the absolute risks:
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Old 08-06-2019, 01:42 PM   #22
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Quote:
Originally Posted by grasshopper View Post
I know Calcium Score is mentioned here a lot and I have one scheduled for the trip home in PHX on the way back from Africa in September. So I looked at the comparison of CS to CAU and this is what I found.

Conclusion
We propose that CACS assessment is useful in the diagnosis of, and as a surrogate marker of ASCVD in asymptomatic high-risk patients. Our results also suggest that carotid artery evaluation may have a valuable predictive method in primary and secondary ASCVD prevention and risk assessment. Therefore, although there are no synergic effects of combining carotid artery evaluation and CACS, carotid ultrasound seems to be a better predictive method for assessing ASCVD events in high-risk populations than CACS.

My guess is because I am symptomatic with good heart health this is why my doc ordered CS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694372/
Ultrasound - no radiation exposure.

I think there is a pretty good radiation exposure with CACS, right? Isnít it essentially a CAT scan?
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Old 08-07-2019, 08:59 AM   #23
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I think there is a pretty good radiation exposure with CACS, right? Isnít it essentially a CAT scan?
Yes, you do get a fair dose of radiation from the CAC scans, which is one reason why I've decided to not have one done (yet anyway.........I might change my mind at some point). Like Braumeister, my triglyceride/HDL ratio is good, and I did have an echcocardiogram done a while back that turned up no issues, so I don't see a good reason to have a CACS done right now.

This is from the abstract of a recent study on how much radiation you get from a CACS:

"The effective radiation dose was reported as mSv. Mean radiation dosing amongst all 82,214 participants was 1.03 mSv, a median dose of 0.94 mSv. The mean radiation dose ranged from 0.76 to 1.31 mSv across the 33 sites involved with the SHAPE program cohort. Subgroup analysis by age, gender or body mass index (BMI) less than 30 kg/m2 showed no variability. Radiation dose in patients with BMI > 30 kg/m2 were significantly greater than other subgroups (Ķ = 1.96 mSv, p < 0.001). The use of 64-MDCT scanners and protocols provide the effective radiation dose for CAC scoring, which is approximately 1 mSv. This is consistently lower than previously reported for CAC scanning, regardless of scanner type, age or gender. In contrast, a greater BMI influenced mean radiation doses."
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Old 08-07-2019, 09:08 AM   #24
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Not much choice if one has a pacemaker.... "No MRI for you".
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