My ultrasound did not reveal atherosclerotic plaque/atheroma. What are my next steps?

If your carotid ultrasound did not reveal atherosclerotic arterial disease (shown as “plaque,” or atheroma/inflammation in your artery wall), that provides some peace of mind. However, there may be disease in your coronary (or other) arteries.

The next step in searching for arterial disease is Coronary Artery Calcium Score (CACS). If you’ve already had this test, we would be happy to review your results. Coronary Artery Calcium Score above zero means you have calcified atherosclerotic plaque/atheroma in your coronary arteries. Non calcified or homogeneous plaque/atheroma is not detected by this test.

If you want a CACS, do a Google search for “Coronary Artery Calcium Score near me” online.  We are  happy to help you get scheduled. Call our office at 217-321-1987 or request a Discovery Call with Dr. Backs to get started.

What does a CureScreen with plaque/atheroma vs. no plaque/atheroma look like?

Click here to see a CureScreen with plaque.

Click here to see a CureScreen with no plaque.

My ultrasound revealed atherosclerotic plaque. What now?

If your screening ultrasound revealed atherosclerotic arterial disease (shown as “plaque,” or inflammation in your artery wall), you can reverse it.  

If left untreated, plaque that does not heal can rupture, forming a blood clot to cause stroke, dementia, heart attack, kidney failure, and other debilitating events.  These events are treated by standard late stage rescue care with stents and surgery. While waiting for treatment, you may suffer a fatal or life-altering stroke or cardiac arrest. You could also accumulate small strokes resulting in vascular dementia over time.

These disasters can be avoided.

At the CureCenter, we reverse atherosclerotic arterial disease, achieving remission to the point it is considered cured, and no longer a threat.  

We will work with your current primary care provider and specialists who provide standard care. They probably won’t understand all that we do. Even if they do, the system in which they practice limits their ability to offer it.  We always welcome a conversation, especially if they will study this website or read “Healthy Heart Healthy Brain.” Standard care tends to be reactive to symptoms and with procedural intervention, sometimes doing more harm than good.  

Stents can fail, requiring further treatment and high-risk blood thinners to prevent closure of the arteries. The CureCenter will help you get optimal results by creating a personalized lifestyle and medical CurePlan. We help you make changes you can live with. We support progress, not expecting perfection.

We recommend medication and supplements based on documented need and monitor the effects, adjusting as needed.

What does a CureScreen with plaque vs. no plaque look like?

Click here to see a CureScreen with plaque.

Click here to see a CureScreen with no plaque.

Be resilient. Be safe. Request a complimentary Discovery Call with Dr. Backs to get started.

What tests are done at the CureCenter to measure arterial disease and its root causes?

The true inflammation nature of arterial disease (which causes heart attack, stroke and dementia) is not the basis of mainstream medical care. New testing methods and technology enable the CureCenter to offer more individualized and effective treatments. 

Tests we perform and recommend include (but are not limited to):

• Carotid Intima Media Thickness (CIMT) Testing: CIMT measures arterial wall thickness. A thicker artery is an inflamed, older and sicker artery. This indicator of arterial inflammation predicts formation of atherosclerotic plaque and related events such as heart attack and stroke.

  Arterial wall thickness (inflammation) is more relevant than “blockage” in predicting new and unstable plaque formation. Unstable plaque rupture is the event we experience as a heart attack or stroke. Proactive optimal care can reverse arterial disease and make your arteries healthier and younger.

• LpPLA2 (PLAC) Test: This enzyme rises when plaque and artery walls are inflamed or “hot.” You want your arteries to be “cool.” LpPLA2 improves with a less inflammatory diet, exercise, reduced insulin resistance, supplements (niacin, and bergamot and medications like statins. It is a fire alarm.

• Myeloperoxidase (MPO): A rise in MPO should trigger a search for inflammation, especially from the mouth. MPO indicates inflammation and erosion of the inner lining of the artery known as endothelium. A sudden rise should trigger a search for the inflammation that can cause arterial inflammation, leading to heart attack or stroke. Think of a caustic chemical spill inside your arteries. Like a skin abrasion, blood clots form and can occlude flow.

• Microalbumin/Creatinine Ratio (MACR): MACR rises when blood pressure and blood glucose are poorly controlled.  This causes dysfunction of the arterial wall endothelium, allowing albumin to leak into the urine in greater amounts. A leaky endothelium fails to protect the intima from processes that lead to inflammation. Think another fire alarm.

For more information about these and other tests, go to

https://www.knowyourrisk.com/

and other information from Cleveland Heart Lab, a major source of our testing

• Haptoglobin Genotype: Your Haptoglobin genotype determines if Vitamin E offers protection or increases risk of arterial disease. In addition, individuals with the Hp 2-2 genome are more sensitive to gluten, forming an inflammatory mediator called zonulin that makes your gut “leaky” and raises the risk of autoimmune disease. 

• Insulin Resistance Testing: Optimally measured through an oral glucose tolerance test, insulin resistance (prediabetes) testing is important in identifying individuals who could be developing vascular complications before a Type 2 Diabetes diagnosis. The glucose tolerance test can identify insulin resistance long before the glucose starts to rise.

  • However, if there is other evidence of insulin resistance that does not require a visit to the lab, we can skip this step. Clues are seen in levels of nonoptimal HbA1c, glucose, triglycerides above 100, low HDL, and presence of small dense LDL (Pattern B).

    The earliest detection for insulin resistance can be measured through body composition testing. At the CureCenter, we use the InBody 570, a device that can monitor insulin resistance response to changes in diet. Reducing insulin resistance is generally healthy for everyone, regardless of risk.

• Homocysteine Testing: Homocysteine elevation increases risk of:

• Osteoporosis - bone thinning

• Atherosclerosis 

• Thrombosis (blood clotting)

• Heart Attack

• Stroke

• Dementia

• Kidney failure

• Neuropathy

Treatment is supplementation with folic acid. Dietary sources of folic acid is leafy greens like spinach and kale.

This paper from the American Heart Association offers a good summary of Homocysteine.

• Coronary Artery Calcium Score (CACS): This CT scan detects mature calcified plaque in the coronary arteries. However, it can miss new noncalcified plaque. This test is not useful in monitoring therapy progress/benefit. We recommend CACS when CIMT does not reveal disease but there is still suspicion of coronary artery disease. If this test detects disease that would have otherwise been undetected, a more proactive approach to address root causes will be encouraged. Beware of the slippery slope to a stress test, stents or surgery. Coronary Calcium Score is a “loss leader”for interventional cardiology programs. Call us first before scheduling further tests.

• Home Sleep Testing and Auto Titrated CPAP: These tests have made diagnosis and management of sleep apnea more affordable and effective. Sleep apnea is a root cause of heart attack, stroke, atrial fibrillation, hypertension and heart failure. Treating it can lower your risk of these events, lower your blood pressure, and reduce arterial inflammation.

• Oral Microbiome Testing: Oral microbiome testing involves taking a sample of saliva, and analyzing it in a laboratory to identify the types of bacteria present. If high risk bacteria species are found, they can contribute to arterial inflammation. In some cases, this can affect management of periodontal disease, which contributes to heart attack and stroke risk. 

  Knowing the nature of your oral “neighborhood” can prompt a more proactive approach to your oral hygiene. If there are dangerous criminals in your neighborhood, you will be more careful to “lock your doors” and augment your security for protrection from invasion. The chronic diseases affected by your oral microbiome include periodontal disease, cardiovascular disease, Type 2 Diabetes and prediabetes, and even some cancers and dementia.