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Newly Published Study on the Value of CAC Score for Risk Assessment

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Biggles2

Well-Known Member
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@bulkbiker and @thefatemperor have been so ahead of the curve on this one:

From the November 2017 Journal of the American Medical Association:
Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome From the Multi-Ethnic Study of Atherosclerosis
“Meaning Assessment of subclinical disease using coronary artery calcium scores may have robust long-term value in prognosticating cardiovascular disease even in those who had diabetes for more than 10 years from the time of coronary artery calcium scoring.”​
https://jamanetwork.com/journals/jamacardiology/article-abstract/2661160

The following is a summary of the above study that appears in the Journal of the American Journal of Cardiology:
Perspective:
Considering the long-term follow-up of >10 years, the study refutes the conclusion that diabetes is a coronary risk equivalent (≥20% 10-year risk of CHD). Amongst those with diabetes and the highest Framingham risk score category of >20%, the CHD event rate was not high if the participant had a CAC score of 0 (4.7 per 1,000 person-years). While important, they do not support the conclusion that a CAC score be obtained in all persons with diabetes and the MetS.​
http://www.acc.org/latest-in-cardio...onary-artery-calcium-score-for-long-term-risk
 
If I have understood this correctly they have concluded that those with Diabetes gain no benefit from having a CAC scan? I am not fully cognisant about what can be done (if anything) for those having had a CAC scan and being found to have a high score but just having evidence that calcification in the muscles of the heart has been identified (it shows up like a beacon) is surely of benefit in terms of stalling/preventing further damage?

Would this have anything to do with the enormous monetary gains by the health industry in NA with use of the stent? Again, just my nasty, suspicious mind at work here.
 
The issue with stents is that they can increase someone's quality of life, but mostly decreases the length of life. Yet this is not explained to people.
 
Does anyone take Magnesium supplements. I've seen before and after scan that show a reduction in calcification in muscles.I need to look it up again.
 
Biggles2 said:
@bulkbiker and @thefatemperor have been so ahead of the curve on this one:

From the November 2017 Journal of the American Medical Association:
Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome From the Multi-Ethnic Study of Atherosclerosis
“Meaning Assessment of subclinical disease using coronary artery calcium scores may have robust long-term value in prognosticating cardiovascular disease even in those who had diabetes for more than 10 years from the time of coronary artery calcium scoring.”​
https://jamanetwork.com/journals/jamacardiology/article-abstract/2661160

The following is a summary of the above study that appears in the Journal of the American Journal of Cardiology:
Perspective:
Considering the long-term follow-up of >10 years, the study refutes the conclusion that diabetes is a coronary risk equivalent (≥20% 10-year risk of CHD). Amongst those with diabetes and the highest Framingham risk score category of >20%, the CHD event rate was not high if the participant had a CAC score of 0 (4.7 per 1,000 person-years). While important, they do not support the conclusion that a CAC score be obtained in all persons with diabetes and the MetS.​
http://www.acc.org/latest-in-cardio...onary-artery-calcium-score-for-long-term-risk
Click to expand...
Not sure I can claim any prescience as it was Ivor Cummings and Dr Gerber who put me onto it in the first place...
 
DavidGrahamJones said:
Does anyone take Magnesium supplements. I've seen before and after scan that show a reduction in calcification in muscles.I need to look it up again.
Click to expand...
I do have a teaspoon of mag citrate most nights to keep me "regular" so when I have my next CAC in a couple of years time I can report back if there has been any improvement although from what I have read so far Vitamin K seems to be the main "treatment" at the moment. Very early days though..
 
Guzzler said:
If I have understood this correctly they have concluded that those with Diabetes gain no benefit from having a CAC scan? I am not fully cognisant about what can be done (if anything) for those having had a CAC scan and being found to have a high score but just having evidence that calcification in the muscles of the heart has been identified (it shows up like a beacon) is surely of benefit in terms of stalling/preventing further damage?

Would this have anything to do with the enormous monetary gains by the health industry in NA with use of the stent? Again, just my nasty, suspicious mind at work here.
Click to expand...

I had it because I wanted to know the state of my heart after 30 odd years of over eating, over drinking and smoking. Type 2 didn't really feature as by then I was pretty well controlled anyway. Also I wanted to have a line in the sand to check that my keto diet wasn't making anything worse. I'll probably have it done every couple of years to see what's going on.
 
ringi said:
The issue with stents is that they can increase someone's quality of life, but mostly decreases the length of life. Yet this is not explained to people.
Click to expand...

I have not seen evidence either way but I recently viewed the 'Widow Maker' documentary about the arguments between those who advocate CAC scans v those on the side of the stent being the only way to go.
As I understand it, surely early diagnosis of calcification would be better than treating those who are lucky enough to survive a heart attack (due to calcium deposits) and then treated by the insertion of a stent?
 
Guzzler said:
As I understand it, surely early diagnosis of calcification would be better than treating those who are lucky enough to survive a heart attack (due to calcium deposits) and then treated by the insertion of a stent?
Click to expand...
Indeed and you want to hear Dr Aseem Malhotra on the over use of stents in the US... If there is a video of him at the PHC conf in Manchester he was less than complementary about his heart surgeon colleagues from what I remember...
 
bulkbiker said:
I had it because I wanted to know the state of my heart after 30 odd years of over eating, over drinking and smoking. Type 2 didn't really feature as by then I was pretty well controlled anyway. Also I wanted to have a line in the sand to check that my keto diet wasn't making anything worse. I'll probably have it done every couple of years to see what's going on.
Click to expand...

With my familial history I would have it done in a heartbeat (no pun intended) but that kind of expense is beyond my pocket. Knowledge is not only power but peace of mind, too.
 
Hi, it is interesting to hear what Ivor Cummins has to say about the CAC, I think he believes that insulin resistance is a major input to calcification. He interviews an expert in the field on his website. I think the ideas are more developed than when this thread started.

Interestingly both Statins and Warfarin cause calcification.
I suppose it could be argued Statins stabilise plaques...perhaps by calcification!? :) Both Statins and Warfarin are Vitamin k antagonists.
Vit k is the antidote for blood loss for a bleeding warfarin user.
Derek
 
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Guzzler said:
I have not seen evidence either way but I recently viewed the 'Widow Maker' documentary about the arguments between those who advocate CAC scans v those on the side of the stent being the only way to go.
As I understand it, surely early diagnosis of calcification would be better than treating those who are lucky enough to survive a heart attack (due to calcium deposits) and then treated by the insertion of a stent?
Click to expand...
In the US, the choice is driven by 'money-money-money. Without the stents most of the Hospitals will go bust. Its their cash cow .
The sad thing is, Stents are of very limited efficacy once there is blockage. Soon the block reappears. More alarming is that it also prevents the use of bypass, which has miles better outcome, at preventing Myocardial infarction. You cannot bypass a stent. So its use impacts the use of a more successful protocol negatively. You can only use a stent 4 times and no more . In the USA where big pharma has hospitals on 'lock down' conflict of interest is not allowing them to make the right decision, even world renowned hospitals like The Mayo Clinic is putting cash before lives.
They are practically running a production line .
 
lindisfel said:
Hi, it is interesting to hear what Ivor Cummins has to say about the CAC, I think he believes that insulin resistance is a major input to calcification. He interviews an expert in the field on his website. I think the ideas are more developed than when this thread started.

Interestingly both Statins and Warfarin cause calcification.
I suppose it could be argued Statins stabilise plaques...perhaps by calcification!? :) Both Statins and Warfarin are Vitamin k antagonists.
Vit k is the antidote for blood loss for a bleeding warfarin user.
Derek
Click to expand...

There are different forms of Vitamin K.

K1 is the Warfarin antagonist, and needs to be taken with great care when blood clotting is an issue, and avoided when on Warfarin.

K2 is the one that helps the body deposit calcium where it is needed (bones, etc) and helps prevent calcification in the arteries (where it is not needed). Overdose of it is unknown. It also has interactions with Vit C, and is part of the Magnesium, C and Vit D 'team' that work together. It is often defiicient in the Western diet. The jury is still out on whether K2 will actively de-calcify arteries. Lots of info by Mercola, Dr Berg as intro to this, but the best info I have seen is some really in depth youtube discussions. Anyone interested just give me a shout, and I will look them up. I supplement with this because I supplement with D3 and magnesium as well.

K3 is (I believe) a potentially dangerous synthetic version of the vit, that should not be taken in excessive quatities, but is the one I know least about.
 
Brunneria said:
There are different forms of Vitamin K.

K1 is the Warfarin antagonist, and needs to be taken with great care when blood clotting is an issue, and avoided when on Warfarin.

K2 is the one that helps the body deposit calcium where it is needed (bones, etc) and helps prevent calcification in the arteries (where it is not needed). Overdose of it is unknown. It also has interactions with Vit C, and is part of the Magnesium, C and Vit D 'team' that work together. It is often defiicient in the Western diet. The jury is still out on whether K2 will actively de-calcify arteries. Lots of info by Mercola, Dr Berg as intro to this, but the best info I have seen is some really in depth youtube discussions. Anyone interested just give me a shout, and I will look them up. I supplement with this because I supplement with D3 and magnesium as well.

K3 is (I believe) a potentially dangerous synthetic version of the vit, that should not be taken in excessive quatities, but is the one I know least about.
Click to expand...
I checked to see if my food contained K2 and was very pleased to find that the chicken and duck liver pate that form a staple part of my diet (I use them mainly in salads) are one of the best sources. Also egg yolk and cheese, so I don't think I will need a supplement as I take for D3 and magnesium.
 
Once naively asked a consultant if I could have a calcium scan done as I have had 36 years plus of glycation damaging my arteries and was told that there was no point because 'all diabetics have high scores'.
I think its the progression of the score that matters as much as the amount of calcification.
Also although we are not in the US our NHS hospitals do get paid by 'activity' so there is an incentive to do a procedure perhaps without explaining the risk/benefits clearly to the patient.
 
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