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Potential Approaches to Reduce CAC (Coronary Artery Calcium) Progression

I was recently discussing statins with a family member and pointed them to my post where I questioned the correlation between lower levels of total cholesterol or LDL-C and cardiovascular events.

They said that they’ve been tracking their CAC score, and whilst it’s still low, it’s been increasing.

I responded by re-iterating that I’m not a doctor or expert on the subject but thought the following was interesting research.

(The only caveat I’d make is that I haven’t looked in detail at the correlation between CAC score and cardiovascular events. It’s taken for granted, but likely worth understanding better).

Statins linked to CAC Progression

1. A 2016 study found that statin use was associated with 31% higher progression of coronary artery calcification vs non-statin use, even adjusting for CV risk factors.

I’ll add to this that there was a slightly lower incidence of coronary events in the statin-taking group.

However, with a P value greater than 0.05, the difference would need to be bigger or the sample size bigger for it to be “statistically significant”. To reiterate, it wasn’t a statistically significant difference.

Additionally:

  • A 2012 study found that “more frequent statin use is associated with accelerated CAC in T2DM patients with advanced atherosclerosis”, however, the sample size was 197 participants.

Interestingly, a third study in 2015 called “High dose and long-term statin therapy accelerate coronary artery calcification” also found similar results.

However, they noted that cardiovascular events did not occur more frequently in statin-treated patients. Which is interesting.

Supplements that may reduce CAC progression

2. Two supplements may help with CAC score – magnesium and vitamin K2. Below are some relevant studies on them:

Magnesium – A study showed that a 50-mg/day increment in magnesium intake was associated with 22% lower CAC.

Vitamin K – appears to play a key role in the transport of calcium around the body. Supplementation may be beneficial. Study source.

Biomarkers linked to CAC Progression

3. Biomarkers that are associated with CAC… Triglycerides, glucose and waist circumference – all of them markers of insulin resistance – predict the progression of coronary artery calcification (source)

So in the image above, it’s showing the percentage of people that had CAC progression, based on their scores (low to high in quartiles) of insulin resistance, triglyceride levels times BMI or trigylcerides times waist circumference.

Essentially, keeping insulin, blood glucose, triglycerides and body fat low, were all associated with less CAC progression.

Roundup

Above we’ve looked at:

  • How statins were found in 1 study to increase CAC progression
  • How 2 supplements may slow CAC progression
  • How 4 biomarkers, all linked to insulin resistance and obesity, have effects on CAC progression.

With links to scientific papers for all of these.

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