My Coronary Calcium Score is 239 in LAD

[browse66]

I had a CT Coronary Calcium Score test last week which showed a score of 239 in LAD, 0 in Left Main, 0 in Left Circumflex and 1 in Right Coronary Artery. My GP has immediately put me on a daily low dose asprin and 20mg Crestor and has requested I have a Mycocardial Perfusion Scan and intends for me to see a cardiologist who he says may do an angiogram and possible stent. I am male, almost 60, 5'11, 92kgs and have a good diet (losts of fruit and veges with little deep fried) although I do not exercise as much as I should. My cholesterol has always been normal and although I was on BP tablets many years for about 8 years I have not been on these for over 8 years since losing weight and my BP is generally stable at 120/80. I am concerned at the prognosis for this condition and whether this is manageable and if it will impact my longevity. Any advice and insight would be greatly appreciated.

[Ajax806]

I'm 43 with a calcium score over 1200, no history or high blood pressure or cholesterol.  The Doc put me on 81mg aspirin and 10mg Simvistatin.  I elected not to an angio, but went through, Cardiac PET, Echo and Stress Echo.  I have a very mild abnormal PET and normal Stress Echo and Echo.  I was told unless I have symptoms, I don''t need the angio, unless I'm desperate to know more.  The Doc says I already have heart disease and since I'm asymptomatic, life style changes and medication are my best bet.  I went to Mayo for a 2nd opinion and they said the same thing.  I'm still here a year later with a ridiculous  calcium score.

[browse66]

Hi and thank you for your comment.

To be honest I haven't at this stage given much thought to the long term benefits or disadvantages of taking a daily asprin plus Crestor; something I intended discussing with a cardiologist when I see him or her. I have done some minor research over the net and seems hard to get a standard and consistent view point. I will be having my stress test on Friday and will see my GP over the weekend so will have a better idea of next steps.

Thanks again.

[ed34]

There could be a reason why Statins wouldn't reduce a calcium score and we have to think about the chemical processes of atherosclerosis to accomplish this. Imagine you have an artery full of soft fat in the wall, which has only half of it covered with plaque. You go to a scan and it shows a reading of 300. Now, in his infinite wisdom, the cardiologist puts you on statins to reduce the inflammation and help stop the disease. However, the disease is already there, just not covered with a plaque plate yet. Over time it will be covered to stop it entering the bloodstream. So the next scan, even though you are on statins, reveals 500-600. Your immediate impression is that statins are doing nothing, but in actual fact their anti inflammatory properties may be preventing further disease from forming. I am not convinced with statins, but I do assume they have those magical anti inflammatory factors. This is why I think only a small dose is required and not the extremeties cardiologists aspire to give you. I think an angiogram would be a far better test, it will give a much better picture as to what is going on in your arteries. It will show if soft fat or plaque is causing the blockage.

[Al Dente]

If I were in your shoes I'd look at my overall condition and what symptoms I've had and discuss with my physician.  Aspirin treatment has its goals and risks, while a relatively high dose of Crestor to treat a CT diagnosed score would leave me with a few questions.  The gold standard is coronary angiography.  If you are having chest pain, pain on exertion, or discomfort I would discuss that in depth with my doctor.  A heart cath does indeed give more information than a CT.  CAD, once properly diagnosed is treatable.

Crestor (rosuvustatin) is very powerful, and can act as "liquid plumber" IMO.  The issue comes down to testing, which ultimately if there's a need suggested by nuclear medicine stress testing may lead you to the cath lab, which will help give a diagnosis.  CAD is manageable with the correct diagnosis.  Crestor is the most powerful statin on the market. Angiography with Fractional Flow Reserve does yield the most information.  CAD, blockages, and cholesterol can be managed.  All of the meds need to be carefully evaluated.   As a patient with a very aggressive form of CAD (early onset diagnosed at 28) it can be managed well.  You need to keep on your doctors, and you need to be disciplined yourself. Good Luck!

[browse66]

Dear Occupant,

I appreciate you having taken the time to comment and share your own experience. I must admit whilst I think I am not worried I know its in the back of my mind and possibly causing me unnecessary stress.

Best Regards............

[Occupant]

I had one 13 years ago with similar results and was taken Statins after that for 11 years and had another one with a score of 786 in the LAD alone (remember everybody will tell you: "Statins will prevent that accumulation of plaque" I stopped the Statins three years ago all together because all the side effects happened to me such as Myopathy, severe Rhabdomyolysis and acute Renal failure - that one sent me to the E.R. Why am I saying all this? You have a long way to go, I am 19 years ahead of you and still here - the world isn't gonna cave in on you..