5 Steps to prevent Heart Disease

Wednesday, April 25, 2018

Confusion over MESA CAC scores

Dr Eades has used a formula with calcium score and volume to determine if the increase in CAC calcium score is significant.  Statins now are well known to increase CAC calcium score but decrease CVD and LDLc and non-HDLc.  This throws off the conclusions of MESA.

 My CAC scores have been 9, 20,  8, 144 after many years of statins and low non-HDLc
 This is my risk with a calcium score of 144 but no mention of CAC calcium volume. Note non-HDLc is used in MESA calculation.
 This is my risk with an earlier CAC score of 8.  Quite significant. Despite DM2 in both calculations, my risk is half at the lower CAC score.  Because the volumes were not taken into account I believe this calculation is flawed with people on statins.  16% of people in MESA were on statins.  They probably had lower LDLc but with higher calcium score thus distorting the results. 
The National Lipid Association came out with new guidelines advising cheap non-HDLc to follow rather than apoB(which requires expensive advanced lipid testing).  

Dr Sniderman objects with this tour de force review here.  

Thus CAC score and LDLc data is often simplified to the point of being wrong.  Must look more closely at these numbers. 

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