Fantastic article. Is it possible to get a cardiac CT scan without any evident issues. I am a relatively healthy 60 year old Dublin male with slight high blood pressure and previously had a successful ablation for AF.
What is the difference between a CTCA and an MRA coronary. Is CTCA replaced coronary angiogram as the best modality for diagnosis of coronary artery disease?
They are complimentary tests. A very simple explanation is that a CT looks at the arteries and and an MRI looks at the muscle. A CT looks at the anatomy of the arteries and an MRI looks the function of the heart. Different tests to answer different questions. One isn't necessarily better than the other. All depends on the question.
Thank you for the clear explanation. Female, high LDL/apoB but 0 CAC at 63. Tried Zypitamag, but had terrible reaction from it. 2nd CAC scan cardiologist wants in January 2024. I will be 67 and then we will reassess. I want to go on lipid lowering, (another statin, PCSK9, if I can afford it). Exercise, BP normal, A1C normal, etc. it’s this darn ApoB at 114!!
There are lots of other statins that could be tried or other non statin therapies that dont cost an arm and a leg - depending on country. Sometimes it takes lots of trial and error. Best of luck
TY so much for answering my question! I am in the US (land of expensive Rx’s)w/PCSK9’s/Inclsiran (worked for Novartis who makes the drug $$$. Can’t use Bem. Acid as I have had tendon rupture which may be one of the small side effects of the drug. I have a smart cardiologist so perhaps rosuvastatin to start. Do you think if my CAC score is over 0, or even 0 should I get a CCTA also just to be sure I don’t have soft plaque. I have tremendous heart disease in my family. As Peter Attia and Thomas Dayspring have said for 50% of folks the first sight of ASCVD is death and for the females in my family that has been the case. Thanks for your time and answering my questions
It sounds like you are good hands and will be able to address your APOB in some way. Re the CTCA I would chat to your cardiologist . Can be very $$$ as an out of pocket test
I think it comes down to your perspective on going on a medication to lower your cholesterol also but it’s worth bringing up. All of this information needs to be seen in context and discussed with your doctor. I can’t really give specific advice but I can try bring up important discussion points with your own doctor.
Thank you for the info. Cardiologist can’t even explain it to me.
Fantastic article. Is it possible to get a cardiac CT scan without any evident issues. I am a relatively healthy 60 year old Dublin male with slight high blood pressure and previously had a successful ablation for AF.
In general - Yes. Always best to chat with your own doctor or cardiologist who did your ablation.
At age 77, I have a CAC of 300. I have read that those, like me, who have spent years in Ultra endurance events tend to have a higher score.
This is true but it appears that even with the higher CAC score endurance athletes have fewer events. https://paddybarrett.substack.com/p/is-too-much-exercise-harmful
Thank you
What is the difference between a CTCA and an MRA coronary. Is CTCA replaced coronary angiogram as the best modality for diagnosis of coronary artery disease?
They are complimentary tests. A very simple explanation is that a CT looks at the arteries and and an MRI looks at the muscle. A CT looks at the anatomy of the arteries and an MRI looks the function of the heart. Different tests to answer different questions. One isn't necessarily better than the other. All depends on the question.
Thank you for the clear explanation. Female, high LDL/apoB but 0 CAC at 63. Tried Zypitamag, but had terrible reaction from it. 2nd CAC scan cardiologist wants in January 2024. I will be 67 and then we will reassess. I want to go on lipid lowering, (another statin, PCSK9, if I can afford it). Exercise, BP normal, A1C normal, etc. it’s this darn ApoB at 114!!
There are lots of other statins that could be tried or other non statin therapies that dont cost an arm and a leg - depending on country. Sometimes it takes lots of trial and error. Best of luck
TY so much for answering my question! I am in the US (land of expensive Rx’s)w/PCSK9’s/Inclsiran (worked for Novartis who makes the drug $$$. Can’t use Bem. Acid as I have had tendon rupture which may be one of the small side effects of the drug. I have a smart cardiologist so perhaps rosuvastatin to start. Do you think if my CAC score is over 0, or even 0 should I get a CCTA also just to be sure I don’t have soft plaque. I have tremendous heart disease in my family. As Peter Attia and Thomas Dayspring have said for 50% of folks the first sight of ASCVD is death and for the females in my family that has been the case. Thanks for your time and answering my questions
It sounds like you are good hands and will be able to address your APOB in some way. Re the CTCA I would chat to your cardiologist . Can be very $$$ as an out of pocket test
Well aware of the study. I think it's a great study and should be practice changing.
I think it comes down to your perspective on going on a medication to lower your cholesterol also but it’s worth bringing up. All of this information needs to be seen in context and discussed with your doctor. I can’t really give specific advice but I can try bring up important discussion points with your own doctor.
Thanks, Dr. Paddy. Going to go for it!