#1175

How common is this? My reading online indicates that doctors/cardiologists consider CCTA, CAC and CIMT to be reliable tests - of course when done by reliable providers (and CIMT takes some skill). I wouldn’t spread doubts about the tests unless you have good reason to do so. But certainly saying that you should take a look at the provider is always good advice in medicine.

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#1176

Do you know specifically what modality of scan they used?

#1177

I know they used ultrasound to examine the carotid arteries. I did the scans through them myself and got the same results - no problems! Next year I am going to get a CAC from the hospital.

This is the provider. I don’t trust their results.

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#1178

I got scammed by LifeLine Screening one year based on an add claiming they do CIMT. After getting their scan and reading the results, they revealed that they only do a simplified version of CIMT that only measures the speed of blood flow in the carotid artery, which only shows signs of plaque after there is 50% or more stenosis. So you can have 50% plaque stenosis and still get an all clear from LifeLine Screening. Next time I got a real CIMT (for $275 in San Diego), which gives you actual Carotid Intima Media Thickness for left and right carotid arteries, plus estimates of plaque stenosis level (if there is significant plaque).

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#1179
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#1180

3 blood biomarkers may be key to predicting cardiovascular risk

For this study, researchers analyzed data from the Women’s Health Study (WHS), funded by the National Institutes of Health (NIH). Since 1993, the study has followed female health professionals ages 45 years and older.

The primary endpoint of the Women’s Health Study was a participant having their first major cardiovascular event, such as a heart attack, stroke, or death from heart-related issues.

All study participants had their blood samples tested for certain biomarkers, including high-sensitivity C-reactive protein (hsCRP), low density lipoprotein cholesterol (LDL-C) — also known as “bad cholesterol” — and lipoprotein(a), or Lp(a), for short.

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#1181

Here’s an interesting CAD Risk Calculator. My 10 year risk is 2.1%. Yet, if I change my age to 80 and leave all else equal, it becomes 16.8%. Why would this be?

http://reference.medscape.com/calculator/192/reynolds-cad-risk

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#1182

Because more plaque has accumulated.

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#1183

Yes, but I have an ApoB and LDL of 48. Would there be that much more plaque? Those values are taken into account. I hear of people saying that below 50, you can avoid CVD. 16.8% doesn’t seem like avoiding CVD.

#1184

I think that calculator is based on if you hadn’t done any lipid lowering treatment the previous decades.

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#1186

I like this better, because you can also set Lp(a) and then separately how much has been reduced, for example LDL-C. Draws 3 different lines.

https://www.lpaclinicalguidance.com/

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#1187

In that SCORE model probably age is the governing parameter, it can be verified by various simulations

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#1188

The model you linked gives me less than half the 10-years risk than the SCORE model, also, it’s easy to get many iterations and is sensitive to LDL-C values, plus extends the risk to 80 years with a continuos signal, I see a significant improvement compared to the SCORE model

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#1189

It has nothing to do with plaque. Old people without plaque have heart attacks, also old people with plaque skate through. As you age, your chance of having a heart attack increase because of things in the blood.

#1190

I think that result is showing the limitations of the calculator more than anything. It has to make assumptions as to your blood lipids “history” over the previous 80 years and that assumption will inevitably be wrong.
A lifelong apob of 48 would mean a pretty low risk even at 80. A mendelian randomization study would probably give you a better idea of the actual risk.

ps well done on 48! good work

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#1191

MINOCA is a fairly rare condition and in many cases still caused by some arterial obstruction.

#1192

About 6%, range 3.5%-15%:

Also depends on the subgroup, women, young people, non-white etc.

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#1193

My understanding is that heart attacks are caused by a blood clot. Blood clots most often come from infected and inflamed areas of the artery which eventually become plaque. If you have a lot of these it’s probably some combo of bad habits and bad genes or in the worst case it’s a statin deficiency. (small joke). The burning question is what causes the eruption and how to best avoid it. I’m trying low carb and colchicine.

Anyway anybody can throw a clot, in many cases it turns out to be a case of too much fibrin. Fibrin is also part of the immune system so there is a tradeoff here. You could live disease free, then die suddenly of a heart attack.

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#1194

IMG_8612
IMG_86121179×1376 121 KB

https://twitter.com/lpa_doc/status/1833060417930703059?s=46&t=zJMJ1xVdRJYEDYz-DHipTw

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#1195

I don’t like the idea of not measuring anything.

1 Like