The Relationship Between Echocardiographic Calcification Score and Grade of Knee Osteoarthritis

Background and objective It has been suggested that knee osteoarthritis (KOA) is associated with the development of calcification and an increased risk of cardiovascular (CV) disease, while the contribution of KOA grade is not clearly known enough. This study aimed to investigate the relationship between the grade of KOA, the echocardiographic calcification score (echo-CCS), and CV risk assessment. Methods This cross-sectional study involved 204 patients diagnosed with KOA and classified according to the Kellgren-Lawrence staging criteria. Echo-CCS was obtained according to the presence of calcification in the aortic valve, aortic root, mitral ring, papillary muscle and ventricular septum. Framingham risk score (FRS) was used for CV risk assessment. Results Calcification was detected in 79.4% of patients. The median FRS, echo-CCS, and high-sensitivity C-reactive protein (hs-CRP) levels increased as the KOA grade increased (p<0.05). A one-grade increase in KOA increased the odds of echo-CCS 1-2 group by 5.15 fold (vs. no calcification group) (OR=5.15, p=0.003), while it increased the odds of echo-CCS ≥3 group by 4.61 fold (vs. echo-CCS 1-2 group) (OR=4.61, p=0.003). Median echo-CSS and hs-CRP were higher in the high CV risk group than in the moderate and low CV risk groups. Conclusion The majority of patients with KOA had intracardiac calcification. An increased KOA grade was associated with higher echo-CSS and FRS. These findings indicate that patients with higher grades of KOA may be predisposed to developing subclinical atherosclerosis.