FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score

Area of Science:

• Cardiovascular Imaging and Intervention
• Bone Metabolism and Osteoporosis Research
• Geriatric Medicine and Public Health

Background:

• Coronary artery calcification (CAC) is a marker of subclinical atherosclerosis and cardiovascular disease (CVD) risk.
• The Fracture Risk Assessment Tool (FRAX) estimates an individual's 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF).
• Understanding potential links between bone health indicators and cardiovascular risk factors is crucial for comprehensive patient assessment.

Purpose of the Study:

• To investigate the association between Fracture Risk Assessment Tool (FRAX) scores and coronary artery calcification (CAC) scores in adults.
• To determine if FRAX-derived fracture risk is independently associated with subclinical coronary atherosclerosis.

Main Methods:

• Retrospective review of 81 adults who underwent both coronary computed tomography (for CAC scoring) and bone mineral density (BMD) studies.
• Fracture risk assessment using the FRAX tool for 10-year probability of MOF and HF.
• Univariate and multivariate linear regression analyses to assess the relationship between CAC score and FRAX indicators.

Main Results:

• A significant positive association was observed between FRAX-determined risks for MOF and HF and CAC score in univariate analysis.
• Multivariate analysis confirmed that CAC score remained significantly associated with four FRAX indicators: right MOF (r=0.45, P<0.001), left MOF (r=0.31, P=0.021), right HF (r=0.38, P=0.001), and left HF (r=0.23, P=0.049).
• The mean age of the study cohort was 55.8 years, with 63.0% being male.

Conclusions:

• Increased risks of MOF and HF, as determined by FRAX, are significantly and independently associated with CAC score.
• These findings suggest a potential link between osteoporosis risk assessment and subclinical coronary artery disease.