Relation of bone mineral density to stress test-induced myocardial ischemia

Area of Science:

• Cardiology
• Endocrinology
• Geriatrics

Background:

• Chest pain is a common symptom requiring diagnostic evaluation for myocardial ischemia.
• Bone mineral density (BMD) assessment, including osteoporosis and osteopenia, is typically performed for skeletal health.
• The relationship between reduced BMD and cardiovascular events is an area of ongoing research.

Purpose of the Study:

• To investigate the association between bone mineral density (BMD) status and the prevalence of stress test-induced myocardial ischemia in patients presenting with chest pain.
• To determine if osteoporosis or osteopenia increases the likelihood of myocardial ischemia compared to normal BMD.

Main Methods:

• Dual-energy x-ray absorptiometry (DXA) scans of the spine and left hip were conducted.
• Participants underwent stress testing to assess for myocardial ischemia.
• Logistic regression analysis was used to control for confounding factors such as hypertension, diabetes, BMI, and age.

Main Results:

• Out of 765 patients, 33% had osteoporosis, 34% osteopenia, and 33% normal BMD.
• Myocardial ischemia was more prevalent in patients with osteoporosis (37%) and osteopenia (31%) compared to those with normal BMD (25%).
• Patients with osteoporosis or osteopenia had a 1.7-fold increased risk of myocardial ischemia, independent of other risk factors.

Conclusions:

• Reduced bone mineral density (osteoporosis and osteopenia) is associated with a higher prevalence of myocardial ischemia in patients with chest pain.
• These findings suggest a potential link between bone health and cardiovascular health.
• Further research may explore underlying mechanisms connecting low BMD and ischemic heart disease.