Primary Hyperparathyroidism Associated With Elevated Coronary Artery Calcium Scores and Increased Cardiovascular Risk

Area of Science:

• Cardiology
• Endocrinology
• Radiology

Background:

• Primary hyperparathyroidism (PHPT) is associated with elevated cardiovascular risk.
• Coronary artery calcium (CAC) scoring quantifies calcific plaque burden for cardiovascular risk assessment.
• The relationship between PHPT and CAC scores remains underexplored.

Purpose of the Study:

• To evaluate the association between PHPT and CAC scores.
• To determine if PHPT independently predicts coronary calcification.
• To explore cardiovascular risk stratification in PHPT patients.

Main Methods:

• Retrospective analysis of 415 patients undergoing CAC scoring (2015-2024).
• Inclusion criteria: concurrent serum calcium and parathyroid hormone levels within one year of CAC testing.
• Comparison of CAC scores (Low-Intermediate: 0-99, High: ≥100) between PHPT and non-PHPT groups; subgroup analyses by risk and PHPT subtype.

Main Results:

• PHPT patients showed a higher prevalence of high CAC scores (≥100) compared to non-PHPT (67% vs 50%, p=.04).
• PHPT independently predicted high CAC scores (OR 1.5, p=.03).
• Male PHPT patients had significantly higher CAC scores than females (median 495 vs 6, p<.01); longer untreated PHPT correlated with severe calcification (OR 1.2, p<.01).

Conclusions:

• PHPT is associated with increased coronary calcific burden and higher cardiovascular event risk.
• Male sex and longer duration of untreated PHPT are linked to greater coronary calcification.
• Routine CAC screening may benefit PHPT populations for cardiovascular risk evaluation.