Welcome to Doctor Warrick's Podcast Channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.
In this podcast, Doctor Warrick Bishop discusses recent studies on cardiac CT imaging and the importance of calcium scoring.
The SCAPIS study, which looked at over 25,000 people between the ages of 50 and 64, found that about 40% of them had plaque. Men had nearly twice as much plaque as women, and there was a decade delay between the amount of plaque that women had compared to men. The study also showed that a small but recognizable number of patients will have non-calcific plaque if they have a zero score. Doctor Bishop uses a zero calcium score as a gatekeeper and tends not to do a CT coronary angiogram unless there are significant symptoms.
The Korean study found that calcium scores tended to be higher and progressed faster in people who exercised. There are two processes occurring that can be driving calcium: calcium can be a marker of plaque formation and stabilization, and if we have a fatty plaque, one of the things that brings that plaque to more stability is that fatty plaque becoming calcified. The process of unstable plaque remains a mystery, and Doctor Bishop remains open to learning.
- The use of CT coronary angiography is an important tool in evaluating plaque in the arteries.
- Men tend to have nearly twice as much plaque as women, and there is a decade delay between the amount of plaque that women have compared to men.
- A zero calcium score is a gatekeeper, and if that score is zero, then the chance of an event is very low in the next three to five years.
- Scores over about 400 have about 40% of cases that had a significant narrowing within one of the arteries.
- Calcium scores tend to be higher and progress faster in people who do exercise.
- Calcium can be a marker of plaque formation and stabilization.
- Calcium presence will tell us about the deposition of cholesterol and how much and an appropriate indicator of propensity to put cholesterol in the arteries.
- Calcium can also show us the process of stabilization.
- The process of unstable plaque remains a mystery.
- Educated patients get the best healthcare.
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