744 Oestrogen as a Potential Shared Mechanism Between Medial Calcification and Intimal Atherosclerosis

Abstract

Intimal atherosclerosis is a well-known cause of cardiovascular disease (CVD). Breast arterial calcification (BAC) is a form of medial arterial calcification and is a common incidental finding that is often thought to be clinically irrelevant on screening mammography. However, recent evidence suggests that BAC may be associated with CVD and cardiovascular risk factors. Menopausal status is also associated with CVD whereas history of hormone replacement therapy (HRT) use is inversely related to CVD. Our objective was to systematically review the available evidence for associations between BAC and menopausal status and HRT. PubMed and EMBED databases were searched up to February 2020 and reference lists of relevant papers were reviewed to identify additional papers. Study quality were graded and a random effects model was used to calculate a pooled OR and 95% CIs for the association of BAC and menopausal status and use of HRT. 16 observational studies were included representing a total of 34,757 women. Three of these were cohort and the rest were cross sectional studies. BAC was associated with menopausal status (OR 2.67; 95% CI 1.50–4.77) and inversely associated with the use of HRT (OR 0.57; 95% CI 0.40–0.80). BAC is associated with menopause and inversely associated with HRT. HRT and menopause are similarly associated with CVD, suggesting a shared hormonal mechanism between medial arterial calcification and intimal atherosclerosis.