Abstract
Objective. To determine the indicators of the bone mineral density (BMD) abnormalities in women with coronary artery disease in the post-menopausal period (СAD). Methods. An open cross-sectional study in parallel groups involved 80 women with coronary artery disease (CAD): stable exertional angina of II–III functional class (mean age 64.59 ± 1.02 years). Depending on the degree of BMD they were divided into 3 groups: group 1 – 19 CAD women with normal BMD; group 2 – 27 CAD women with osteopenia; group 3 – 34 CAD women with osteoporosis. The control selected group consisted of 11 healthy women of the corresponding age. With the help of ultrasound densitometry, FRAX algorithm and bone biomarkers levels assessment we investigated structural and functional state of the bone tissue. Results. It was acknowledged that in women with CAD in the postmenopausal period, depending on the severity of BMD loss, there is a significant decrease in the T- and Z-criteria and an increase in the 10-year risk of developing osteoporosis fractures. The development of postmenopausal osteoporosis (PMOS) combined with CAD was accompanied with an increase in the level of inflammation, neoangiogenesis and bone remodeling biomarkers (osteoprotegerin, ostecalcin, VEGF-A), which also have multi-directional correlative interrelationships with the structural and functional indicators of the BMD state (T, Z-criterion, 10-year risk of osteoporosis fractures). ROC-analysis results show the cut-off values at the osteopenia and osteoporosis stage for osteoprotegerin level equal to 223.76 pg/ml and 224.44 pg/ml; for osteocalcin level – 15.89 ng/ml and 16.71 ng/ml, for VEGF-A level – 112.52 pg/ml and 123.31 pg/ml correspondingly. Conclusions. The levels of osteoprotegerin and/or ostecalcine and/or VEGF-A can be used as a screening method for early diagnosis of BMD loss and stratification of patients in the category of increased risk of osteopenia and osteoporosis.
Highlights
Coronary artery disease takes the leading place among the diseases of the circulatory system [1,2]: in Europe, its share is about 38% in the structure of prevalence and 19.5% in the structure of total mortality [3,4]
Depending on the bone mineral density (BMD) state, all the patients were divided into 3 groups: group 1 – 19 CAD women with normal BMD (T-criterion is more than 1 SD; mean age 64.24 ± 2.12 years); group 2 – 27 CAD women with osteopenia (T-criterion is from -1 SD to -2.5 SD; mean age 65.22 ± 1.52 years); group 3 – 34 CAD women with osteoporosis (T-criterion is less than -2.5 SD; mean age 69.39 ± 1.62 years)
The level of osteoprotegerin increased if compared to the control selected group: by 5.10 % in the group of women with coronary artery disease and osteopenia, by 6.53 % in the group of women with coronary artery disease and osteoporosis (Р < 0.05)
Summary
Coronary artery disease takes the leading place among the diseases of the circulatory system [1,2]: in Europe, its share is about 38% in the structure of prevalence and 19.5% in the structure of total mortality [3,4]. In recent years simultaneously with coronary artery disease the problem of osteoporosis has got a special medical and social significance, which is due to the increasing prevalence of this disease due to the aging of the population, the lack of timely detection, prevention and significant impact on the quality of patients’ life [8]. The importance of this pathology is due to its dire consequences – non-traumatic spine and tubular bone fractures, influencing the increase in the disability and mortality of aged patients [8,9,10]. That is why postmenopausal osteoporosis (PMOS), in which the bone mineral density changes are associated with the onset of menopause is one of the most common forms of this pathology [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
