Coronary calcium scan - UPDATED

Today, the result of my coronary calcium scan:  Zero.  Again.  Same as 7.5 yrs ago.

The scan comes with a disclaimer:

TECHNIQUE: Computerized axial tomography of the mediastinum was performed without contrast material. This study is performed without intravenous contrast and its sensitivity for pathology is reduced. This includes the detection of neoplasms, abscess, pulmonary embolism, and aortic dissection.

I asked Dr. Gary about a more detailed scan, but he said this was good enough, without me exhibiting any obvious pathology.  

Researching on this test, I found:

"...guidelines make a large distinction between CAC = 0 and CAC >0. ... Once detected, CAC progresses... Because of the exponential nature of CAC, its relationship with risk is logarithmic, that is, each successive increase in CAC translates into a smaller increment in risk. Thus, quantifying high scores versus very high scores contributes only moderately to improved risk prediction. An important concept is that most of risk stratification occurs with the CAC score range between 0 and 100."

So, it seems that CAC = 0 is way better than CAC = 1, because once established, it progresses.

In terms of mortality, I read that:

Cancer was the leading cause of death for patients with baseline CAC = 0, whereas CVD overtook cancer above a threshold of CAC >300.

OK, so I'm probably more likely to die of cancer than heart disease.  

My scan did show a hepatic cyst on my liver, so maybe that will be my death?  These are somewhat common, usually benign, and in 18% of the population.  Anyway, added a liver cancer test to my Ulta test package.  I'm getting both lipid fractionation tests, standard lipid panel, alipoprotein profile (A&B), and the AFP liver cancer screening...  all these tests for less than $170 with the Halloween discount.  I'll probably do it in Dec sometime.  Afterward, I'll be able to further assess my CVD risk and make a decision about statins.  

Dr. Gary had some encouraging words:  

"Zero means you have incredibly low cardiac risk. We usually don’t repeat this as we don’t have a handle on what progression means in terms of risk. Zero make less of a case for a statin drug. Hepatic cysts are very common. No need to pursue this further. Means nothing. Annual Skin cancer screening with a dermatologist and colonoscopies every 5-10 years are what I would recommend for cancer screening. Also, prostate cancer screening with annual PSA testing IS worthwhile despite historical commentary that it is not. And you do not need a stress echo or ECG. Given your cardiopulmonary fitness and CAC = 0, an ECG and/ or stress test will add nothing to determine your risk."

And... JP said it is immoral and impure to take drugs.

UPDATE:

I spoke with Allan T., orthopedic surgeon, fastest man in the world over age 60 (60m, 100m).  He sent me this form that assesses the 10-year risk of the following ASCVD events: 1) CHD death, 2) Nonfatal MI, 3) Resuscitated cardiac arrest, 4) Coronary revascularization in patient with angina (bypass?).

According to this form, my risk of a 'cardiac event' in the next 10 yrs is not 'incredibly small' but is listed at 6.9%.   

Allan has values similar to mine and worse, has a family history with his father having a heart attack at age 55.  But he eschews statins.  

Although not a cardiologist, he agrees with my theory that 'running the engine hot' or pushing HR to max a couple times a week may have anti-arteriosclerosic benefits.