Relationship between coronary artery calcification and osteopenic syndrome in men with coronary heart disease

Objective: to investigate the relationship between coronary artery calcification (CAC) and osteopenic syndrome in men with coronary heart disease (CHD).

Subjects and methods. A total of 102 men aged 51 to 75 years (mean age 61 (55; 65) years) with verified CHD were examined. Bone mineral density (BMD) and its T-score of LI–IV and femoral neck were determined by dual-energy X-ray absorptiometry. According to the T-score, the men were divided into 3 groups: 1) 33 (32.4%) patients with osteoporosis (OP) (T-score <-2.5); 2) 48 (47.0%) patients with osteopenia (OSP) (T-score -1 to -2.5) and 3) 21 (20.6%) examinees with normal BMD (NBMD) (T-score ≥-1). In all the patients, CAC was quantified by multislice spiral computed tomography. The investigators calculated CA calcium scores by the Agatston method and rated the extent of calcification: none (0), minimal (1–10), mild (11–100), moderate (101–400), or severe (>400).

Results and discussion. Severe CAC was detected in 57.8% of the men; moderate CAC was in 25.5%; mild CAC was in 6.9; minimal CAC was in 2.0%; and none CAC was in 7.8%. In the OP group, the majority (69.7%) of the patients had severe CAC; 15.1% had moderate CAC, 6.1% had mild CAC; 3.0% had minimal CAC; CAC was undetected in 6.1% of cases. In the OSP group, there was severe CAC in 60.4%, moderate CAC in 33.3%, mild CAC in 4.2%, and minimal CAC in 2.1%. The patients without CAC were absent in this group. In the NBMD group, 33.3% of the examinees were recorded to have severe CAC; 23.8% had moderate CAC; 14.3% had mild CAC; CAC was undetected in 28.6%. Minimal CAC was also undetected in the patients of this group. There was a preponderance of patients with severe CAC in all the groups of those identified by the T-score. The extent of CAC was significantly lower in the NBMD group than in the OSP group (p<0.05). CAC was significantly more frequently absent in the NBMD group than in the low BMD group (p<0.05). There was an inverse correlation between Agatston CAC scores and T-scores of the femoral neck (r=-0.25; p=0.01), T-scores of LI–IV (r=-20; p=0.04), and the BMD of the femoral neck (r=0.23; p=0.02) and LI–IV (r=-0.19; p=0.04). Low BMD was associated with severe CAC, which lends credence to the relationship between vascular wall calcification and osteopenic syndrome in the men with CHD.

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