A CT heart scan is the only rational and precise way to detect and quantify hidden coronary heart disease. It is far better than silly methods like cholesterol, risk-scoring processes, or waiting for the appearance of symptoms.
But you can go one step better: two heart scans conducted over time to calculate–or STOP–the otherwise inevitable growth of coronary atherosclerosis.
In truth, you have enormous control over whether or not your heart scan score progresses at the typical rate of 25% per year, but it won’t be achieved with silly efforts such as statin drugs, a low-fat diet, or “everything in moderation.”
Here’s a question I’ve been wondering about for a long time. Dr. Davis discusses in his books and the video “How To Reduce Your Heart Scan Score” that you can reduce or reverse your heart scan score and mentions as an example of reducing it from say 900 down to 300 or 400 and he has seen this for himself with many, many of his patients in the past. What I never have heard or read is exactly where does the calcium that acts like a protective cap and makes the plaque stable go to? If a score goes from 900 down several hundred points means that the calcium has gone. One of the concerns from some doctors is that for instance people taking vitamin k2, that supposedly clears calcium from the arteries, is that it would make a stable plaque turn into a dangerous unstable plaque by removing the protective “cap”. That’s assuming vitamin k2 works that way. It would be very helpful to know if Dr. Davis could explain his theory about where the calcium went when his patient’s scores were reduced. He’s never explained this. Just curious.
R. Taylor wrote: «…reduce or reverse your heart scan score … where does the calcium … go to?»
I don’t recall anyone asking that previously. I suspect the answer is: where it’s supposed to go. But it could also be: no place harmful. Where do the byproducts of any wound healing go?
My understanding is that merely arresting the score growth causes “events” to drop dramatically (absent other provocations beyond what was causing the plaque), and that reversing it lowers risk even further. I’ve not heard of any secondary risk being elevated.
Reversing plaque is a very slow process, slower than typical wound healing. So I’d conjecture that whatever healing debris is liberated is at a very low level that poses no threat. The Ca in particular probably just becomes serum Ca again.
re: «…protective “cap”…»
Where are you seeing that meme? I know it’s popular spin with statin pushers. Here’s Dr. Davis on it 10 years ago on the old TrackYourPlaque forum: “The notion that calcium is protective has been debunked at several levels, including studies of shear effects on plaque, not to mention the clear-cut graded effect of increasing calcium scores on events.”
re: «One of the concerns from some doctors is that for instance people taking vitamin k2, that supposedly clears calcium from the arteries, is that it would make a stable plaque turn into a dangerous unstable plaque by removing the protective “cap”.»
The producer of a robust-potency K2 supplement product has arrested and reversed his own score, has outlived one doctor’s mortality projection by some 13 years now, and seems unconcerned.
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I think it’s unsafe to say that someone’s risk of a heart attack is zero if their calcium score drops from 700 to 500 in a year, as per the example given by Dr. Davis.
No one’s risk of a heart attack is ever zero.
Even people with a zero calcium score can suffer a heart attack.
Heart attacks can occur from a rupture of soft plaque in people with a zero calcium score.
I support the idea of getting a heart scan test but don’t be lead into a false sense of security if you get a low or zero score.
I had considered getting a CAC test in the months leading up to my sudden, out of the blue with no prior symptoms, heart attack at 56. But being a procrastinator I hadn’t gotten around to it yet. Two stents later including the LAD (the “widow maker!”), RCA and another (the name of which I’ve forgotten) which was attempted and failed and I was happy to be alive and no longer in pain.
Later the surgeon showed me the video of the surgery and explained what she was doing and what was happening with my heart as she was doing it. I mentioned to her I’d read about the CAC test and had considered doing it and asked if it would have caught my problem. She said, no, it wouldn’t have without a dye contrast and they typically don’t do dye contrast for the CAC test.
So, I’m confused. Is the calcium score different from hardened plaque like I have or does the plaque have to contain calcium in order to be seen by a regular, dye contrast free CAC test and mine doesn’t contain calcium? I know I should have asked her then but I was so surprised by her reply I didn’t think to ask and just continued to watch the video in fascinated horror.
Bill van Dijk wrote: «Two stents later…»
As you’ve probably deduced, at this point you can’t now get a CAC scan that results in a meaningful total Agatston score. If you can find someone willing to run a scan, and interpret it, you might still get a baseline for the unstented vessels going forward. I also understand that the more advanced forms of CIMT can be useful for monitoring where CAC can’t be used (and this wouldn’t be the freebie carotid ultrasound in the van at the TrendyMart this weekend).
re: «I mentioned to her I’d read about the CAC test and had considered doing it and asked if it would have caught my problem. She said, no,…
I’m not so sure. Although a total CAC score tells you nothing about where the calcium is, the report almost always includes by-artery sub-score, and there is usually a radiologist’s report, which might note specific local trouble spots. As I understand it though, actual stenosis is not gauged. In any event, you might have generated a score that would have prompted further investigation. Moot at this point.
re: …it wouldn’t have without a dye contrast and they typically don’t do dye contrast for the CAC test.»
I think that’s what’s called a CCTA. It came up on the subscription forum recently, with a doctor providing some insight on when it’s used — and that appears to be in symptomatic individuals, which you weren’t.
re: «Is the calcium score different from hardened plaque like I have or does the plaque have to contain calcium in order to be seen by a regular, dye contrast free CAC test and mine doesn’t contain calcium?»
As I understand it (from one of Dr. Davis’ older books), the CT (or EBT) calcium scan detects calcium in the plaque (whether “hard” or “soft”) and the calcium volume statistically represents 20% of the total plaque.
re: «…just continued to watch the video in fascinated horror.»
So what’s your strategic plan? Although consensus med is impressively competent at installing stents and CABG, they are (putting it diplomatically) useless at preventing what brought you to that point, and, going forward, correcting that still-present disease etiology.
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