Exactly what I said. From the same Attia article:
In another study analyzing outcome data from the Multi-Ethnic Study of Atherosclerosis, investigators found that 10-year event rates for individuals between the ages of 55-64 with a CAC score of zero were 3.1% compared to 16.7% for people with a CAC score 300 or above.
A CAC score of zero may be the best predictor we have of low estimated CVD risk, but it does not grant one cardiac immortality, as you can see from these studies. There are a number of modifiable risk factors that should not be ignored because of a score of zero, for example, managing blood pressure, lipoproteins, insulin, smoking status, inflammation, glucose, stress, exercise, and sleep may all play a role in disease progression.
I’ll take a CAC of zero over non-zero all day long, make no mistake about it. If you only concern yourself with a 10-year risk horizon, it’s a mighty fine tool. But if you want to think about risk beyond that, you need to concern yourself not only with how many times you’ve had a break-in, but also the risk posed by the neighborhood you live in.
And here’s a new study - 2024. @Candleflower from a cardiovascular standpoint appears to be asymptomatic.
Coronary artery disease (CAD) remains a significant health concern, and coronary artery calcium (CAC) scoring is a powerful tool for risk stratification, primarily in asymptomatic individuals. Notably, a CAC score of 0 often indicates a low risk for CAD and major adverse cardiac events and an excellent long-term prognosis.1 However, its diagnostic accuracy in symptomatic patients remains debated.
The “zero calcium paradox” raises questions about the true predictive value of a zero calcium score.2 Although often reassuring, it should not be the sole criterion for ruling out significant CAD. A lack of coronary calcification does not necessarily indicate an absence of atherosclerotic plaque. Although CAC scoring is traditionally used for asymptomatic individuals, its use is increasingly extending to symptomatic populations, necessitating caution in interpretation. The “power of zero” mainly applies to asymptomatic patients, with the exception of younger individuals (<40 years) with cardiovascular risk factors such as diabetes mellitus and hypercholesterolemia.
No one is saying that it’s a “get out of jail free” card. But @Candleflower your metabolic health looks good and we all recommend that you start a low dose statin. I don’t think you have to worry.
People here tend to hear “high ApoB” and they run screaming from the room, like they had just come face-to-face with Satan himself. Yes, ApoB is important, but in your case with zero CAC, I wouldn’t get too worked up about it - just start a statin - you’re way ahead of most people.
