Just when I thought I understood

…a freebie from Peter Attia tells me otherwise

My combo treatment has dropped my Lp(a) and my ApoB lipoprotein levels very handily so, for once, I don’t appear to be an outlier. In case others aren’t so fortunate, a worthwhile read.

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This is not in any way a recommendation. This is just some information. I have no idea what the side effects are.

Which drug reduces LP A?

Pelacarsen. The antisense oligonucleotide AKCEA-APO(a)-LRx (Pelacarsen) effectively reduces Lp(a) levels (up to 80%) by impairing the synthesis of apolipoprotein(a) (apo(a)) [39].Sep 20, 2021

Well, for me, a combo of statin (side effects of which I believe you’re familiar with) plus PCSK9 inhibitor which hasn’t manifest any side effects just yet. Stacked up against the side effects of ASCVD…which includes, but isn’t limited to, sudden cardiac death…I think, I’ll roll with the prescribed therapy.

FWIW, sudden cardiac death with no prior symptoms or significant disability isn’t that bad of an option, all things considered. Unfortunately, there’s no real way to guarantee that’ll be the outcome.

The calcium scans are interesting. I had one done in 2018 and then again in late 2019. I was told I have no problem. My score was 163 in 2019. The calcium was scattered across my chest arteries with no build up or blockage which is a problem.

I became a type II diabetic in 2012. This year I went a cardiologist. He explained my situation using the archived 2019 scan for me to view with him.

He stated he has seen people with very high calcium scores and zero problems.

The importance of seeing the scan…there is no plaque.

I am on 5mg of Crestor. My weight loss of 50 lbs has taken down my cholesterol but there are not studies of people losing 50 lbs long term. The doctors need to play it safe. I am at about 1.5 years without gaining any of the weight back. If anything I can lose more weight going forward.

Well, I have a very high calcium score with zero problems…if by “problems” your cardiologist meant actual symptoms of disease. It was such a surprise to me and my primary care physician that I was tempted to think it was someone else’s results. Husband ran it by a colleague whose judgement he trusts…an intervention cardiologist at an academic center…who immediately suggested a CT angiogram to detect degree of blockage, evidence of ongoing disease in the form of atherscletic plaques (which cannot be detected by a CAC scan…because they’re not yet calcified) An even bigger stunner given my exercise capacity etc.

Can’t decide which is worse…the realisation that one’s own poor choices have caused a preventable problem or having the problem anyway in spite of excellent custodianship.

One of my last posts on the old Running Fools board towards the start of the year when I was bellyaching about my road to recovery after my bunion surgery concerned this conundrum. I mentioned that I was something of a Poster Child for getting struck by so called “preventable” diseases…squamous and basal cell carcinomas when I’ve never been a sun worshipper, bunions when I’ve never worn winkle pickers/stiletto heels (too young in the late 1950s/early '60s…old enough to know better now they’re popular again) Made the facetious remark that, judging by experience so far, I’ve got an excellent chance of waking up one day with periodontal disease. Little did I realise.

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It is not measured by the CAC but if a cardiologist looks over the video they know what they are looking at. I have no plague.