Abstract
We evaluated whether breast arterial calcification (BAC) is associated with the progression of coronary atherosclerosis in asymptomatic women. This retrospective observational cohort study analysed asymptomatic women from the BBC registry. In 126 consecutive women (age, 54.5 ± 7.0 years) who underwent BAC evaluation and repeated coronary computed tomography angiography (CCTA) examinations, the coronary arterial calcification score (CACS) and segment stenosis score (SSS) were evaluated to assess the progression of coronary arterial calcification (CAC) and coronary atherosclerotic plaque (CAP). CAC and CAP progression were observed in 42 (33.3%) and 26 (20.6%) women, respectively (median interscan time, 4.3 years), and were associated with the presence of BAC and a higher BAC score at baseline. Women with BAC demonstrated higher CAC and CAP progression rates and showed higher chances for CAC and CAP progression during follow-up (p < 0.001 for both). In multivariable analyses, the BAC score remained independently associated with both CAC and CAP progression rates after adjustment for clinical risk factors (β = 0.087, p = 0.029; and β = 0.020, p = 0.010, respectively) and with additional adjustment for baseline CACS (β = 0.080, p = 0.040; and β = 0.019, p = 0.012, respectively) or SSS (β = 0.079, p = 0.034; and β = 0.019, p = 0.011, respectively). Thus, BAC may be related to the progression of coronary atherosclerosis and its evaluation may facilitate decision-making.
Highlights
Health Registry Study for Bone, Breast, and Coronary Artery Disease) demonstrated that breast arterial calcification (BAC) evaluation in asymptomatic women provides an independent and incremental value to clinical risk factors for the prediction of subclinical coronary atherosclerosis[6]
The BACS is independently associated with the annualised progression of CAC and coronary atherosclerotic plaque (CAP)
To minimise the effect of variations in the interscan duration, we evaluated the association between BAC and annualised CAC and CAP progression (CAC and CAP progression rates)
Summary
Health Registry Study for Bone, Breast, and Coronary Artery Disease) demonstrated that BAC evaluation in asymptomatic women provides an independent and incremental value to clinical risk factors for the prediction of subclinical coronary atherosclerosis[6]. If coronary atherosclerosis progression could be predicted in individual patients by evaluating BAC, in addition to clinical risk factors, clinical decision-making regarding further cardiac tests and preventive medication would be facilitated. Given that millions of women undergo mammography, the simultaneous evaluation of breast cancer and cardiovascular disease risk has tremendous appeal. To date, whether BAC evaluation is associated with coronary atherosclerosis progression has not been studied. In this retrospective cohort study, we aimed to evaluate whether the presence and severity of BAC on mammography is associated with coronary atherosclerosis progression in asymptomatic women
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