Nov 02 2024 25 mins 23
Over 30 years ago, I help set up the first CT heart scan device in Wisconsin, one of the first in the entire midwest. This was so long ago that it was really an electron beam tomogrraphy, or EBT, device that predated the more recently developed CT devices. The point is that these devices acquired images quickly, about 1/10th of a second. This is important because the heart is perpetually in motion through various cycles of its beating rhythm, with motion also provided by breathing. But these devices allowed us to precisely quantify calcium in the coronary arteries of the heart, the arteries that close and cause heart attacks. My friend, Dr. John Rumberger while at the Mayo Clinic, performed studies demonstrating that calcium consistently occupies 20% of total atherosclerotic plaque volume in the coronary arteries. In other words, quantifying calcium in the coronary arteries served as a gauge or dipstick for total atherosclerotic plaque in the heart’s arteries.
Some years later, cardiologist Dr. Arthur Agatston, whose name you may recognize from his popular South Beach Diet books, developed a scoring system for coronary calcium, yielding something that came to be called an “Agatston score”: the higher the Agatston or calcium score, the more atherosclerotic plaque was present in the coronary arteries. Subsequent research has shown that the Agatston or calcium score is, by a long stretch, the best predictor of future cardiovascular events, far better than crude measures like cholesterol and these scores, in the 30+ years since my team and I started doing these scans, have become well-established as predictors of cardiovascular events like heart attack.
But what to do with the score—can it be stopped? Can it be reduced? That is the topic for this episode of the Defiant Health podcast, highlighting what my colleagues call, even to this day, “optimal medical therapy” that has repeatedly been shown to NOT work and the answers lie elsewhere, answers that I shall discuss.
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