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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association between bone mineral density and coronary plaque burden in patients with coronary artery disease: a
Guang Geng1, Zhen Li2, Shuai Wang3
1Department of Medical Imaging, the Second Hospital of Hebei Medical University.
Insights
Bone mineral density (BMD) in men with coronary artery disease (CAD) was inversely associated with coronary artery calcification (CAC) but not plaque burden. In postmenopausal women, BMD showed an inverse association with CAC, but not plaque burden.
Area of Science:
- Cardiology
- Radiology
- Osteoporosis Research
Background:
- Coronary artery disease (CAD) and osteoporosis are prevalent chronic conditions.
- Understanding the relationship between bone mineral density (BMD) and coronary calcification is crucial for comprehensive patient risk assessment.
Purpose of the Study:
- To investigate the association between lumbar vertebral bone mineral density (BMD) and coronary artery calcification (CAC) and coronary plaque burden.
- To evaluate these associations in patients with established atherosclerosis or CAD.
Main Methods:
- A cohort of 290 men and 177 postmenopausal women with confirmed CAD underwent computed tomography (CT) for BMD measurement (L1-L2).
- Coronary artery calcium score (CACS) and modified Gensini score (plaque burden) were quantified.
- Multivariate regression and Lasso regression analyses were employed to assess associations between BMD, CACS, and plaque burden.
Main Results:
- In men, BMD was inversely associated with CACS and the presence of CAC, even after adjustment for confounders.
- In postmenopausal women, BMD was inversely associated with CACS and CAC presence in unadjusted models, but these associations did not persist in adjusted models.
- BMD did not correlate with the modified Gensini score (plaque burden) or overall CAD prevalence in either sex.
Conclusions:
- Lumbar vertebral BMD is inversely associated with coronary artery calcification (CAC) in men with CAD.
- This inverse association between BMD and CAC was not consistently observed in postmenopausal women after adjustment for covariates.
- No significant correlation was found between BMD and coronary plaque burden (modified Gensini score) in either men or postmenopausal women with CAD.
Purpose:
To evaluate the association between osteoporosis and coronary calcification and coronary plaque burden in patients with atherosclerosis and coronary artery disease (CAD).
Methods:
This study included 290 men and 177 postmenopausal women with angiography-confirmed atherosclerosis or CAD who underwent chest multidetector row computed tomography covering L1-L2 between September 2020 and October 2021. Quantitative computed tomography was used to measure the lumbar vertebra's bone mineral density (BMD). The coronary artery calcium score (CACS) and total coronary plaque burden were quantified using the Agatston and modified Gensini scores, respectively. Associations between BMD and CACS and modified Gensini scores were assessed using multivariate regression analysis. Lasso regression was used in model selection.
Results:
In men, BMD was inversely associated with CACS [ β = -0.24; 95% confidence interval (CI), -0.35 to -0.13; P < 0.001) and coronary artery calcification (CAC) presence [odds ratio (OR) = 0.71; 95% CI, 0.52-0.96; P = 0.03) in the unadjusted model. After adjusting for age, modified Gensini score, prior percutaneous coronary intervention and hypertension, BMD was inversely associated with CACS ( β = -0.11; 95% CI, -0.22 to -0.01; P = 0.04). In postmenopausal women, BMD was inversely associated with CACS ( β = -0.24; 95% CI, -0.39 to 0.10; P < 0.001) and CAC presence (OR = 0.66; 95% CI, 0.47-0.92; P = 0.01) in the unadjusted model but no other models ( P > 0.05). In both sexes, BMD did not correlate with the modified Gensini score or CAD prevalence (all P > 0.05).
Conclusion:
In patients with coronary atherosclerosis and CAD, BMD of the lumbar vertebra correlated inversely with CACS in men but not postmenopausal women. Additionally, BMD did not correlate with the modified Gensini score in both sexes.
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