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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Breast arterial calcifications (BACs) found on screening mammography and their association with cardiovascular
Michelle A Rotter1, Peter F Schnatz, Allen A Currier
1Department of Obstetrics, University of Connecticut School of Medicine, Farmington, CT, USA.
Insights
Breast arterial calcifications (BACs) detected on mammograms are linked to higher risks of cardiovascular disease. These calcifications may serve as a practical indicator for coronary artery disease in women.
Area of Science:
- Radiology
- Cardiology
- Women's Health
Background:
- Breast arterial calcifications (BACs) are frequently observed on screening mammograms but often not reported.
- The clinical significance of BACs, particularly concerning cardiovascular health, requires further investigation.
Purpose of the Study:
- To investigate the association between mammographically detected BACs and coronary artery disease (CAD) risk factors.
- To evaluate the correlation of BACs with a history of atherosclerotic cardiovascular disease (ASCVD).
- To estimate the relative risk of ASCVD in women with BACs.
Main Methods:
- A cohort of 1,919 women undergoing screening mammography provided consent for questionnaire completion and mammogram analysis.
- Certified radiologists, blinded to questionnaire data, assessed mammograms for the presence of BACs.
- Questionnaires collected data on major CAD risk factors and hormone therapy use.
Main Results:
- BACs were detected in 14% of women (268 out of 1,919).
- BAC-positive women showed significantly higher prevalence of cardiovascular risk factors including age, hypertension, hypercholesteremia, diabetes mellitus, and menopause (P < 0.001).
- BACs were strongly associated with ASCVD events (OR=2.29, 95% CI: 1.40-3.74), independent of age.
Conclusions:
- BACs are associated with an increased prevalence of cardiovascular risk factors and morbidity.
- Mammographically detected BACs may serve as a valuable, practical indicator for CAD risk in women.
Objective:
Breast arterial calcifications (BACs) are common but unreported findings on screening mammograms. This study correlated mammographically detected BACs with coronary artery disease (CAD) risk factors and a history of atherosclerotic cardiovascular disease (ASCVD), estimating the relative risk of ASCVD in patients with BACs.
Design:
Women arriving for breast cancer screening mammography gave their consent to complete a questionnaire and to allow their mammograms to be analyzed independently for the presence of BACs by certified radiologists, who were blinded to the results of the questionnaire. The questionnaire assessed major risk factors for CAD and gathered information on hormone therapy use.
Results:
Of the 1,919 women with results, 268 were BAC positive, giving a BAC prevalence of 14%. Five cardiovascular risk factors (age, hypertension, hypercholesteremia, diabetes mellitus, and menopause) were significantly more prevalent in the BAC-positive population (P < 0.001). The BAC-positive group also had a significantly higher (P < 0.001) occurrence of ASCVD events (angina, previous myocardial infarction, previous abnormal angiography, previous stroke, and previous coronary artery bypass graft). Multiple logistic regression analysis found BACs to be strongly associated with ASCVD events (odds ratio = 2.29, 95% CI: 1.40-3.74) as compared with other CAD risk factors (including hypertension, cigarette smoking, diabetes mellitus, age, and family history of ASCVD). The association of BAC with ASCVD was present even after accounting for age.
Conclusions:
BACs are associated with an increased prevalence of both cardiovascular risk factors and cardiovascular morbidity. BACs may be a practical tool to use as a risk indicator for CAD in women.
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