Matthew Budoff, MD - Coronary Calcium Scoring for Risk Stratification and Guidelines

[@oibal60]

Thanks for this. Wifey and I are on a daily regimen of D3,K2 and Mg.

[@georgereese2066]

Outstanding!!!!

[@keithhorn9894]

Great presentation of CAC scores and usefulness! However, the statin conclusions from the St. Francis study are incorrect cited. Note that the authors of the St. Francis study state that "Treatment also failed to significantly reduce the primary end point, a composite of all ASCVD events.(96.9% vs. 9.9%, p=0.08)." The p-value supports the null hypothesis except perhaps for the subset with CAC over 400. I have copied the results section of the paper cited below. Results Treatment reduced total cholesterol by 26.5% to 30.4% (p < 0.0001), low-density lipoprotein cholesterol by 39.1% to 43.4% (p < 0.0001), and triglycerides by 11.2% to 17.0% (p ≤ 0.02) but had no effect (p = 0.80) on progression of coronary calcium score (Agatston method). Treatment also failed to significantly reduce the primary end point, a composite of all ASCVD events (6.9% vs. 9.9%, p = 0.08). Event rates were related to baseline calcium score (pre-specified analysis) and may have been reduced in a subgroup of participants with baseline calcium score >400 (8.7% vs. 15.0%, p = 0.046 [not a pre-specified analysis]).

[@valluriramarao6337]

I am 77 yr I have coronary calcium score nearly 600 5yrs back under went tests (TMT.ECHO.ECG)TWICE by two eminent cardiologist wo told no angio is necessary as iam on regular walking .on ROZUVA20 with clopidogril.i developed microvascular complications- CKD (creatinine1.3mg)mildRetinal changes. Peripheral neuro .Maintaining with drugs. Do I need to undergo re check .My BP is 120/70 on Metaprolol25mg.My DM is under control Hb A1c 6.2% May I know I need to add VitD3& K2 please advise

[@jkdeb3822]

Thanks

[@rickpierce5867]

I wish there were links for all of the references

[@Werebat]

Is there anything that can be done for people who have extremely high CAC scores other than aspirin and statin therapy? I am a 43 year old male with a CAC score of 156(!), and calcific aortic valve stenosis. I have read about Aged Garlic Extract (in fact, I think Dr. Budoff did some studies involving it), Vitamin K2, and extreme diets, but no mainstream cardio organizations seem to be saying anything about what can be done to reverse or even halt the progression of CAC. I know it progresses maybe 10-20% per year, which puts my in some pretty dire straits by my early 60s, and seems to bar me from ever reaching my 80s. Sometimes, because of my extremely high score for my age, it feels like this test was just a test that tells me I'm doomed.

[@RickBillings]

Hi Werebat, you may want to take a look at this product as it might help. www.VascularFitness.net

[@canalroadadventures5079]

I recently learned that I have a CAC score of 102. I am a 70-year-old male. My strategy for stopping progression is first and foremost diet and secondarily supplements (K2, garlic extract, omega-3, et.al.) and a statin. I am on a ketogenic diet. This diet reduces your small, dense LDL by greatly reducing triglycerides and significantly improving your other lipid markers (Total cholesterol, HDL, LDL). SD-LDL is the primary cause of atherosclerosis. For understanding the advantages of keto, low-carb and high-fat diets, I recommend watching KZbin videos of Jeff Volek, Stephen Phinney, and Ken Sikaris.

[@robrae14]

Check your Lp(a)!!!

[@frank1847]

Hi Robin what is Lp(a)?.

[@Nmethyltransferase]

Your doctor should treat you as if you're at the same risk level as someone's who has just had their first heart attack. And here's what they ought to do... 1.) Maximally tolerated statins, e.g. 40 mg rosuvastatin. If you can't tolerate statins at all, you should on a PCSK9 inhibitor. Your LDL should be below 70; the lower the better. Add second (or even third) medications, if necessary, to get there. 2.) Rivaroxaban 2.5 mg twice daily, aspirin 81-325 mg daily, plus clopidogrel 75 mg. 3.) Either an ACE inhibitor or maximally tolerated dose of telmisartan. If neither is appropriate in your case (or you can't tolerate either), use maximally tolerated nebivolol or carvedilol. As long as your blood pressure is in the triple digits and you don't feel dizzy, it's fine! The lower the better. 4.) Meformin extended release, 1500 mg at bedtime. There's no benefit to going above this dose. You can titrate it by 500 mg every week (or even longer) to improve tolerance. 5.) Optionally, you can add niacin (immediate release only, up to 6 grams a day in divided doses), Vascepa (4 grams a day), and CoQ10 (100 mg, times a day). You can also eat natto, or take 180 mcg (or more) of Vitamin K2 daily. If you're deficient in Vitamin D, you can supplement with that as well. Personally, I just take 2000 IU daily, and don't pay attention to blood levels. 6.) Viagra is available generic now, as is Cialis. If you're interested and can afford to pay for them out of pocket, you can take them daily to improve endothelial function. Or you can ask your doctor if they can prescribe you a nitrate, e.g. isosorbide. Get bloodwork every six months, and repeat the CAC every 18-24 months. You may not experience reversal--and that's okay! You just need to see that the progression stops. If there's no progression, your risk comes down to the same as someone with a CAC score of zero.

[@dan-312]

sad that after 10 years, this video only has 21k views. How many people wouldn't need a statin if they took one of these test every 3 years? How many people could have prevented a heart attack if getting one of these tests every three years?

[@calsadventures3672]

I'm 59 years old have a coronary calcium score of 1825 any suggestions would be appreciated

[@chazitup13]

Contact William Bestermann, Jr. in S.C. [e-mail], he can reverse your numbers..God speed

[@MsGonetoPot]

look up videos of IVOR CUMMINS AND Michael Eades, and Nina Teicholz (Recommend her Book, " The BiG FaT Surprise"). They have so much information...The one thing you need do is Get off sugar, carbs and eat real foods, meat. You need foods That are high in fat and low in carbs. keto would Benefit you. your score is very high, alarmingly high, Take This super seriously. Good luck, wish you well

[@TheBeautyanna]

Cal's Adventures my husband just had his score 3 weeks a go agatston score 914, the volume score 666 which is the right one, the same day we started Low carb high fat, vitamin C, D3, K2, selenium, magnesium, omega 3 2000, low dosage aspirin, coq10 organs pills lots of greens exercise! Watched Ivon Cummins pod cast and have help from Dr Blanchet in colorado, someone from his staff is helping us, told us about everything and also niacin with flush! Good luck to us!

[@bradentonguy50]

@@TheBeautyanna Where do you get omega 3 in that dosage?

[@TheBeautyanna]

@@bradentonguy50 now we are trying krill oil from dr mercola is higher in fat

[@forextrader2464]

Why do drs just say here take these drugs. why not tell me what to do to cure my high cac score? Statins are trash. Its sad that drs on the internet will tell patients what matters more than our own drs.