Abstract
The trabecular bone score (TBS) was found to be significantly associated with moderate coronary artery calcification (CAC). The aim of this study was to further explore the association between TBS-adjusted Fracture Risk Assessment Tool (FRAX) and CAC score in women. The electronic medical record database of a regional teaching hospital in southern Taiwan yielded women who received both coronary computed tomography and bone mineral density (BMD) measurement during their general health examination. Health history, anthropomorphic measurements, laboratory results, BMD, and T-scores were obtained. TBS values were calculated from database spine dual-energy X-ray absorptiometry files. Linear regression analyses tested the association between CAC score and 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) determined by TBS-adjusted FRAX. Of the 116 women (mean age 55.8 years) studied, 24.1% had osteoporosis. Simple linear regression showed a significant association of CAC score with an increase in MOF and HF risk as measured by TBS-adjusted FRAX. In multiple linear regression adjusted for potential confounders, CAC score remained significantly associated with TBS-adjusted FRAX for right MOF (p = 0.002), left MOF (p = 0 006), right HF (p = 0.005), and left HF (p = 0.015). In conclusion, clinicians should be vigilant to the potential increased risk of coronary events among women with increased TBS-adjusted FRAX for MOF and HF.
Highlights
Vascular calcification is closely related to vascular injury and inflammation [1]
We found that trabecular bone score (TBS) was significantly associated with moderate CAC in patients [11] and that the fracture risk assessment tool (FRAX) was significantly and independently associated with the CAC score [12]
Multiple linear regression analyses of CAC scores and TBS-adjusted FRAX were conducted, adjusting for age, hypertension, hyperlipidemia, and systolic blood pressure, and the independent variables that the simple linear regression analysis found were significantly associated with CAC scores
Summary
Coronary artery calcification (CAC) can independently predict the presence of coronary atherosclerotic plaque [2] and future cardiac events [3]. A cohort study of 10,377 asymptomatic individuals found that CAC was a strong predictor of morality, and it could significantly improve outcome classification compared with the Framingham risk score [4]. A population-based study of 6722 men and women showed that the CAC score was a strong predictor of incident coronary events in various ethnic groups, including white, black, Chinese, and Hispanic adults in the United States [6]. According to the 2018 American Heart Association and American College of Cardiology (AHA/ACC) cholesterol management guideline, CAC testing is encouraged to implement shared decision making and to individualize treatment plans, for primary atherosclerotic cardiovascular disease prevention in asymptomatic patients and those with borderline and intermediate risk [7]
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