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AlJabri M, Alghamdi M, Collado-Mesa F, Abdel-Mottaleb M. Recurrent attention U-Net for segmentation and quantification of breast arterial calcifications on synthesized 2D mammograms. PeerJ Comput Sci 2024; 10:e2076. [PMID: 38855260 PMCID: PMC11157579 DOI: 10.7717/peerj-cs.2076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/30/2024] [Indexed: 06/11/2024]
Abstract
Breast arterial calcifications (BAC) are a type of calcification commonly observed on mammograms and are generally considered benign and not associated with breast cancer. However, there is accumulating observational evidence of an association between BAC and cardiovascular disease, the leading cause of death in women. We present a deep learning method that could assist radiologists in detecting and quantifying BAC in synthesized 2D mammograms. We present a recurrent attention U-Net model consisting of encoder and decoder modules that include multiple blocks that each use a recurrent mechanism, a recurrent mechanism, and an attention module between them. The model also includes a skip connection between the encoder and the decoder, similar to a U-shaped network. The attention module was used to enhance the capture of long-range dependencies and enable the network to effectively classify BAC from the background, whereas the recurrent blocks ensured better feature representation. The model was evaluated using a dataset containing 2,000 synthesized 2D mammogram images. We obtained 99.8861% overall accuracy, 69.6107% sensitivity, 66.5758% F-1 score, and 59.5498% Jaccard coefficient, respectively. The presented model achieved promising performance compared with related models.
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Affiliation(s)
- Manar AlJabri
- Department of Computer Science and Artificial Intelligence, Umm Al-Qura University, Makkah, Makkah, Saudi Arabia
- King Abdul Aziz University, Jeddah, Makkah, Saudi Arabia
| | - Manal Alghamdi
- Department of Computer Science and Artificial Intelligence, Umm Al-Qura University, Makkah, Makkah, Saudi Arabia
| | - Fernando Collado-Mesa
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, United States
| | - Mohamed Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, United States
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2
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Ibrahim M, Suleiman ME, Gandomkar Z, Tavakoli Taba A, Arnott C, Jorm L, Barraclough JY, Barbieri S, Brennan PC. Associations of Breast Arterial Calcifications with Cardiovascular Disease. J Womens Health (Larchmt) 2023; 32:529-545. [PMID: 36930147 DOI: 10.1089/jwh.2022.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Cardiovascular diseases (CVD), including coronary artery disease (CAD), continue to be the leading cause of global mortality among women. While traditional CVD/CAD prevention tools play a significant role in reducing morbidity and mortality among both men and women, current tools for preventing CVD/CAD rely on traditional risk factor-based algorithms that often underestimate CVD/CAD risk in women compared with men. In recent years, some studies have suggested that breast arterial calcifications (BAC), which are benign calcifications seen in mammograms, may be linked to CVD/CAD. Considering that millions of women older than 40 years undergo annual screening mammography for breast cancer as a regular activity, innovative risk prediction factors for CVD/CAD involving mammographic data could offer a gender-specific and convenient solution. Such factors that may be independent of, or complementary to, current risk models without extra cost or radiation exposure are worthy of detailed investigation. This review aims to discuss relevant studies examining the association between BAC and CVD/CAD and highlights some of the issues related to previous studies' design such as sample size, population types, method of assessing BAC and CVD/CAD, definition of cardiovascular events, and other confounding factors. The work may also offer insights for future CVD risk prediction research directions using routine mammograms and radiomic features other than BAC such as breast density and macrocalcifications.
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Affiliation(s)
- Mu'ath Ibrahim
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Mo'ayyad E Suleiman
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Ziba Gandomkar
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Amir Tavakoli Taba
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Clare Arnott
- Cardiovascular Program, The George Institute for Global Health, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Louisa Jorm
- Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Jennifer Y Barraclough
- Cardiovascular Program, The George Institute for Global Health, Newtown, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Sebastiano Barbieri
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Patrick C Brennan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
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3
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Okşul M, Şener YZ, Sarıkaya Y, Sarıkaya S, Yıldırım A, Canpolat U, Akpınar MG, Hazırolan T, Özer N, Tokgözoğlu SL. Breast artery calcification as an opportunistic predictor of cardiovascular disease. Ir J Med Sci 2022; 192:625-631. [PMID: 35971037 DOI: 10.1007/s11845-022-03127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atherosclerotic cardiovascular disease is still the leading cause of mortality for women. Breast cancer screening with mammography is recommended in all women aged over 40 years. AIMS Whether breast artery calcification (BAC) is associated with cardiovascular disease is not clear. We aimed to evaluate the association between BAC and the presence of coronary atherosclerosis determined by CT. METHODS All patients who underwent both mammography and coronary CT angiography between January 2010 and December 2016 were screened, and patients with a duration of less than 12 months between CT and mammography were included. RESULTS A total of 320 women were included and BAC was detected in 47 (14.6%) patients. BAC was correlated with age and CT coronary calcium score. Both the frequency of critical coronary artery stenosis (34% vs 10.6%; p = 0.001) and CT coronary calcium score (5.5 vs 0; p = 0.001) was significantly higher in patients with BAC. The absence of BAC was a strong predictor of the absence of significant coronary artery disease (p = 0.001). BAC was independently associated with all-cause mortality after excluding patients with breast cancer (HR: 5.32; p = 0.013). CONCLUSION Breast artery calcification is associated with coronary calcium score and significant coronary stenosis. A high BAC score is related to increased mortality.
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Affiliation(s)
- Metin Okşul
- Cardiology Department, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Yusuf Ziya Şener
- Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Yasin Sarıkaya
- Radiology Department, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Sevtap Sarıkaya
- Radiology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Arzu Yıldırım
- Cardiology Department, Medipol University Hospital, Istanbul, Turkey
| | - Uğur Canpolat
- Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Tuncay Hazırolan
- Radiology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Necla Özer
- Cardiology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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4
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Yoon YE, Yun BL, Kim KM, Suh JW. Breast Arterial Calcification: A Potential Biomarker for Atherosclerotic Cardiovascular Disease Risk? Curr Atheroscler Rep 2021; 23:21. [PMID: 33772359 DOI: 10.1007/s11883-021-00924-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE OF REVIEW We aimed to summarize the current evidence regarding the association between breast arterial calcification (BAC) and atherosclerotic cardiovascular disease (ASCVD) in women and discuss the potential role of BAC in the risk stratification and preventive approaches for ASCVD. RECENT FINDINGS BAC has emerged as a potential women-specific risk marker for ASCVD. Although BAC presents as a medial calcification of the arteries, notably different from the intimal atherosclerotic process, current evidence supports a correlation between BAC and ASCVD risk factors or subclinical and clinical ASCVD, such as coronary artery disease or stroke. As millions of women undergo mammograms each year, the potential clinical application of BAC in enhanced ASCVD risk estimation, with no additional cost or radiation, has tremendous appeal. Although further research regarding optimal risk assessment and management in women with BAC is required, the presence of BAC should prompt healthy cardiovascular lifestyle modifications.
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Affiliation(s)
- Yeonyee E Yoon
- Department of Radiology, New York-Presbyterian Hospital, and Weill Cornell Medicine, New York, NY, USA.
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Jung-Won Suh
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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5
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Gennarelli M, Jedynak A, Forman L, Wold E, Newman RB, Dhand A, Kapoor A, Jafri F, Pal S, Pandav J, Cho E, Devarajan A, Yandrapalli S, Herman D, Aronow WS, Nabors C. The potential impact of mammographic breast arterial calcification on physician practices in a primary care setting. Future Cardiol 2021; 17:1241-1248. [PMID: 33433235 DOI: 10.2217/fca-2020-0180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This study sought to determine breast arterial calcification (BAC) prevalence in a primary care setting and its potential use in guiding further cardiovascular workup. Materials & methods: A radiologist reviewed 282 consecutive mammograms. Characteristics of BAC-positive and negative women were compared. Results: BAC prevalence was 34%. BAC-positive women were older (mean age: 60 vs 52, p < 0.001), had higher mean 10-year cardiac risk (11 vs 6%, p < 0.001), more hypertension (65 vs 40%, p < 0.001) and coronary artery disease (10 vs 2%, p = 0.0041), statin (50 vs 32%, p = 0.006) and aspirin use (28 vs 16%, p = 0.012). Thirty-seven percent (33/96) of BAC-positive women could potentially benefit from further cardiac testing. Conclusion: Mammography identifies BAC-positive women with low traditionally assessed cardiovascular risk who might benefit from further cardiovascular workup.
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Affiliation(s)
- Melissa Gennarelli
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Andrzej Jedynak
- Department of Radiology, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Leanne Forman
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Eric Wold
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | | | - Abhay Dhand
- Department of Surgery, Director, Transplant Infectious Diseases, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Aromma Kapoor
- Department of Medicine, Division of Nephrology, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Firas Jafri
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Suman Pal
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Jay Pandav
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Eunna Cho
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Anusha Devarajan
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Srikanth Yandrapalli
- Department of Cardiology, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Daniella Herman
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Wilbert S Aronow
- Department of Cardiology, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
| | - Christopher Nabors
- Department of Medicine, Division of General Internal Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA
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Breast arterial calcifications as a biomarker of cardiovascular risk: radiologists' awareness, reporting, and action. A survey among the EUSOBI members. Eur Radiol 2020; 31:958-966. [PMID: 32851451 PMCID: PMC7813731 DOI: 10.1007/s00330-020-07136-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022]
Abstract
Objectives To investigate the knowledge of radiologists on breast arterial calcifications (BAC) and attitude about BAC reporting, communication to women, and subsequent action. Methods An online survey was offered to EUSOBI members, with 17 questions focused on demographics, level of experience, clinical setting, awareness of BAC association with cardiovascular risk, mammographic reporting, modality of BAC assessment, and action habits. Descriptive statistics were used. Results Among 1084 EUSOBI members, 378 (34.9%) responded to the survey, 361/378 (95.5%) radiologists, 263 females (69.6%), 112 males (29.6%), and 3 (0.8%) who did not specify their gender. Of 378 respondents, 305 (80.7%) declared to be aware of BAC meaning in terms of cardiovascular risk and 234 (61.9%) to routinely include BAC in mammogram reports, when detected. Excluding one inconsistent answer, simple annotation of BAC presence was declared by 151/233 (64.8%), distinction between low versus extensive BAC burden by 59/233 (25.3%), and usage of an ordinal scale by 22/233 (9.5%) and of a cardinal scale by 1/233 (0.4%). Among these 233 radiologists reporting BAC, 106 (45.5%) declared to orally inform the woman and, in case of severe BAC burden, 103 (44.2%) to investigate cardiovascular history, and 92 (39.5%) to refer the woman to a cardiologist. Conclusion Among EUSOBI respondents, over 80% declared to be aware of BAC cardiovascular meaning and over 60% to include BAC in the report. Qualitative BAC assessment predominates. About 40% of respondents who report on BAC, in the case of severe BAC burden, investigate cardiovascular history and/or refer the woman to a cardiologist. Key Points • Of 1084 EUSOBI members, 378 (35%) participated: 81% of respondents are aware of breast arterial calcification (BAC) cardiovascular meaning and 62% include BAC in the mammogram report. • Of those reporting BAC, description of presence was declared by 65%, low versus extensive burden distinction by 25%, usage of an ordinal scale by 10%, and of a cardinal scale by 0.4%; 46% inform the woman and, in case of severe BAC burden, 44% examine cardiovascular history, and 40% refer her to a cardiologist. • European breast radiologists may be ready for large-scale studies to ascertain the role of BAC assessment in the comprehensive framework of female cardiovascular disease prevention. Electronic supplementary material The online version of this article (10.1007/s00330-020-07136-6) contains supplementary material, which is available to authorized users.
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7
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The correlation of deep learning-based CAD-RADS evaluated by coronary computed tomography angiography with breast arterial calcification on mammography. Sci Rep 2020; 10:11532. [PMID: 32661231 PMCID: PMC7359346 DOI: 10.1038/s41598-020-68378-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 06/18/2020] [Indexed: 12/16/2022] Open
Abstract
This study sought to evaluate the association of breast arterial calcification (BAC) on breast screening mammography with the Coronary Artery Disease-Reporting and Data System (CAD-RADS) based on Deep Learning-coronary computed tomography angiography (CCTA). This prospective single institution study included asymptomatic women over 40 who underwent CCTA and breast cancer screening mammography between July 2018 and April 2019. CAD-RADS was scored based on Deep Learning (DL). Mammograms were assessed visually for the presence of BAC. A total of 213 patients were included in the analysis. In comparison to the low CAD-RADS (CAD-RADS < 3) group, the high CAD-RADS (CAD-RADS ≥ 3) group, more often had a history of hypertension (P = 0.036), diabetes (P = 0.017), and chronic kidney disease (P = 0.006). They also had a significantly higher level of LDL-C (P = 0.024), while HDL-C was lower than in the low CAD-RADS group (P = 0.003). BAC was also significantly higher in the high CAD-RADS group (P = 0.002). In multivariate analysis, the presence of BAC [odd ratio (OR) 10.22, 95% CI 2.86–36.49, P < 0.001] maintained a significant associations with CAD-RADS after adjustment by meaningful variable. The same tendency was also found after adjustment by all covariates. There was a significant correlation between the severities of CAD detected by DL based CCTA and BAC in women undergoing breast screening mammography. BAC may be used as an additional diagnostic tool to predict the severity of CAD in this population.
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Fathala AL, Alfaer F, Aldurabi A, Shoukri M, Alsergani H. Breast arterial calcification on mammography does not predict coronary artery disease by invasive coronary angiography. Ann Saudi Med 2020; 40:81-86. [PMID: 32241166 PMCID: PMC7118238 DOI: 10.5144/0256-4947.2020.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The relationship between breast arterial calcification (BAC) and angiographic coronary artery disease (CAD) is uncertain. Some studies have shown a positive association between BAC and angiographically proven CAD, while other studies have shown no association. OBJECTIVE Examine the association between visually detected BAC on mammography and CAD found on invasive coronary angiography (ICA) in women and compare the frequency of risk factors for CAD between women with normal and abnormal ICA. DESIGN Retrospective. SETTING Single tertiary care center. PATIENTS AND METHODS A review of the radiology databases was performed for female patients who underwent both ICA and mammography within six months of each other. Cases were excluded if there was a history of CAD, such as coronary artery bypass graft or prior percutaneous coronary intervention. MAIN OUTCOME MEASURES BAC as a predictor of obstructive CAD on ICA. SAMPLE SIZE 203 Saudi women RESULTS: The association between age at catheterization and ICA was statistically significant ( P=.01). There was no association between BAC and abnormal ICA ( P=.108). Women with abnormal ICA were older than women with a normal ICA ( P=.01). There was a higher frequency of CAD risk factors among the patients with abnormal ICA, except for smoking. In the multiple logistic regression model, ICA was associated with age, a family history of CAD, diabetes mellitus, hypertension and hypercholesterolemia. BAC-positive women were older than BAC-negative women ( P=.0001). BAC was associated with age, diabetes, hypertension, and chronic kidney disease in the multiple logistic regression model. CONCLUSIONS BAC on mammography did not predict angiographically proven CAD. There was a strong association between BAC and age and many other conventional CAD risk factors. LIMITATIONS Relatively small sample, single-center retrospective study. CONFLICT OF INTEREST None.
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Affiliation(s)
- Ahmed L Fathala
- From the Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fatoun Alfaer
- From the Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Alaa Aldurabi
- From the Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammed Shoukri
- From the Department of Epidemiology and Biostatistics, Faculty of Health Sciences, University of Western Ontario, London, Ontaria, Canada
| | - Hani Alsergani
- From the Department of Cardiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Yoon YE, Kim KM, Lee W, Han JS, Chun EJ, Ahn S, Choi SI, Yun BL, Suh JW. Breast Arterial Calcification is Associated with the Progression of Coronary Atherosclerosis in Asymptomatic Women: A Preliminary Retrospective Cohort Study. Sci Rep 2020; 10:2755. [PMID: 32066804 PMCID: PMC7026413 DOI: 10.1038/s41598-020-59606-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/30/2020] [Indexed: 11/09/2022] Open
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.
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Affiliation(s)
- Yeonyee Elizabeth Yoon
- Departments of Cardiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Min Kim
- Departments of Endocrinology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wonjae Lee
- Departments of Cardiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong Soo Han
- Departments of Health Promotion Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Ju Chun
- Departments of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soyeon Ahn
- Departments of Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sang Il Choi
- Departments of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,Departments of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo La Yun
- Departments of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea. .,Departments of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jung-Won Suh
- Departments of Cardiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea. .,Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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10
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Bui QM, Daniels LB. A Review of the Role of Breast Arterial Calcification for Cardiovascular Risk Stratification in Women. Circulation 2019; 139:1094-1101. [PMID: 30779650 DOI: 10.1161/circulationaha.118.038092] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease continues to be the leading cause of death among women in the United States. One of the barriers to improving cardiovascular disease outcomes in women is the lack of reliable, effective screening modalities. Breast arterial calcification has emerged as a potential risk stratification tool. Localized deposition in the media of the artery, known as Mönckeberg medial calcific sclerosis, is notably different from the intimal atherosclerotic process commonly associated with coronary artery disease. Nonetheless, studies favor a correlation between breast arterial calcification and cardiovascular risk factors or coronary artery disease, defined as coronary artery calcification on computed tomography scan or both nonobstructive and obstructive lesions on angiography. Since a majority of women over the age of 40 undergo yearly breast cancer screening with mammography, measurement of breast arterial calcification may offer a personalized, noninvasive approach to risk-stratify women for cardiovascular disease at no additional cost or radiation. Mammography has the potential to alter the course of the leading cause of death in women, heart disease, through the evaluation of breast arterial calcification and identification of opportunities for prevention. Current evidence supports the universal reporting of breast arterial calcifications and personalized patient-provider discussions to more aggressively treat cardiac risk factors through targeted medical therapies or healthy lifestyle changes.
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Affiliation(s)
- Quan M Bui
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego
| | - Lori B Daniels
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego
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11
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Evaluation of mammography detected breast arterial calcifications as a predictor of coronary cardiac risk. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0095-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cardiovascular disease is one of the leading causes of death so detection of breast arterial calcifications on annually screening mammography can predict the possibility of future cardiovascular problems.
Results
The 100 female patients were divided into two groups according to age: 1st group with age ranging from 40 to 60 years and 2nd group with age ranging from 61 to 80 years. There is increased percentage of cardiac cases among the BAC-positive patients in the 2nd group with a significant p value = 0.022 and this proved that there was a correlation between presence of BAC and being a cardiac case in the 2nd group, unlike the 1st group which showed no correlation.
Conclusion
Incidental detection of breast arterial calcification in mammography in females above 60 years warrants further evaluation of their coronary atherosclerotic state and risk of future development of serious coronary artery disease.
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12
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Screening Mammography Findings in Women With Chronic Kidney Disease on a Renal Transplant Waiting List. Clin Breast Cancer 2019; 19:e433-e439. [PMID: 30837172 DOI: 10.1016/j.clbc.2019.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/19/2019] [Accepted: 01/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The incidence of breast cancer has been reported to be increased in people with chronic kidney disease (CKD). Thus, breast cancer screening is stated to be mandatory. However, it is as yet unclear what age group or what type of breast structure indicate a need for mammography. This study aimed to evaluate the effects of age and breast parenchymal density on mammography findings. The rate of detection of calcification from mammographies increased in dialysis patients with CKD. The associations of calcifications with comorbid pathologies were also evaluated. PATIENTS AND METHODS Patients were divided into the two age groups of 40 to 49.9 years and ≥ 50 years. The patients were asked about smoking habits, hypertension, diabetes mellitus, the pathology that caused CKD, state of hemodialysis, and, if relevant, the type and duration of dialysis. RESULTS The mean age of the 55 patients included in this study was 54.8 years, and 78.2% (n = 43) were ≥ 50 years old. The rate of malignancy across the entire group was 3.6%. No association was found between breast arterial calcification and cigarette smoking, hypertension, diabetes mellitus, state of dialysis, duration of dialysis, and breast parenchymal density in any age group. CONCLUSION A pretransplantation evaluation of CKD patients may include a breast screening program for patients aged 40 to 49.9 and for the patients aged ≥ 50. Breast parenchymal density was demonstrated to have no effect on the findings, and no association was found between calcifications and comorbid pathologies.
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Kidney function, proteinuria and breast arterial calcification in women without clinical cardiovascular disease: The MINERVA study. PLoS One 2019; 14:e0210973. [PMID: 30653590 PMCID: PMC6336275 DOI: 10.1371/journal.pone.0210973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 01/04/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breast arterial calcification (BAC) may be a predictor of cardiovascular events and is highly prevalent in persons with end-stage kidney disease. However, few studies to date have examined the association between mild-to-moderate kidney function and proteinuria with BAC. METHODS We prospectively enrolled women with no prior cardiovascular disease aged 60 to 79 years undergoing mammography screening at Kaiser Permanente Northern California between 10/24/2012 and 2/13/2015. Urine albumin-to-creatinine ratio (uACR), along with specific laboratory, demographic, and medical data, were measured at the baseline visit. Baseline estimated glomerular filtration rate (eGFR), medication history, and other comorbidities were identified from self-report and/or electronic medical records. BAC presence and gradation (mass) was measured by digital quantification of full-field mammograms. RESULTS Among 3,507 participants, 24.5% were aged ≥70 years, 63.5% were white, 7.5% had eGFR <60 ml/min/1.73m2, with 85.7% having uACR ≥30 mg/g and 3.3% having uACR ≥300 mg/g. The prevalence of any measured BAC (>0 mg) was 27.9%. Neither uACR ≥30 mg/g nor uACR ≥300 were significantly associated with BAC in crude or multivariable analyses. Reduced eGFR was associated with BAC in univariate analyses (odds ratio 1.53, 95% CI: 1.18-2.00), but the association was no longer significant after adjustment for potential confounders. Results were similar in various sensitivity analyses that used different BAC thresholds or analytic approaches. CONCLUSIONS Among women without cardiovascular disease undergoing mammography screening, reduced eGFR and albuminuria were not significantly associated with BAC.
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14
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Breast Arterial Calcification in the Mammogram Report: The Patient Perspective. AJR Am J Roentgenol 2019; 212:209-214. [DOI: 10.2214/ajr.18.20171] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Yildiz A, Yildiz S, Toprak H, Kocas C. Correlation between Breast Arterial Calcification and the 10-year fatal cardiovascular risk by means of the SCORE Risk System. Pak J Med Sci 2018; 34:1341-1346. [PMID: 30559782 PMCID: PMC6290236 DOI: 10.12669/pjms.346.16031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: The aim of this study was to investigate the relationship between Breast Arterial Calcification (BAC) on mammography and the 10-year fatal Cardiovascular Disease (CVD) risk by using SCORE risk system. Methods: The study was conducted from September 2013 to July 2014. A total of 66 women with BAC and 66 age-matched controls without BAC were analyzed. The groups were compared with respect to demographics, clinical, reproductive, laboratory parameters, and 10-year fatal CVD risk. Results: The mean ages of the women in the study was 54.0 years (40-85 years). Hypertension, systolic blood pressure, levels of serum total cholesterol and the calculated SCORE risk were higher in the BAC (+) group than in the BAC (-) group (p=0.04, p=0.031, p=0.046, and p=0.038 respectively). Multivariate analysis showed that none of them was independent factor of BAC on mammograms, only the 10-year fatal CVD risk was close to being statistically significant (OR:1.17, CI:0.98-1.38, p=0.06). Conclusion: BAC on mammography was found to be related to the 10-year fatal CVD risk as calculated by the SCORE risk score system. Additional large-scale prospective studies are required to further assess whether BAC can be considered a useful screening tool for CVD risk prediction in women who screened for breast cancer by mammography.
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Affiliation(s)
- Ahmet Yildiz
- Ahmet Yildiz, Istanbul University, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
| | - Seyma Yildiz
- Seyma Yildiz, MD. Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Huseyin Toprak
- Huseyin Toprak, MD. Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Cuneyt Kocas
- Cuneyt Kocas, MD. Istanbul University, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
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Suh JW, Yun BL. Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease. J Cardiovasc Imaging 2018; 26:125-134. [PMID: 30310879 PMCID: PMC6160812 DOI: 10.4250/jcvi.2018.26.e20] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 11/22/2022] Open
Abstract
Breast arterial calcifications (BAC), frequently observed on screening mammography, have been considered as an incidental finding without increased risk for breast cancer. They are medial calcifications and therefore, are indicative of arteriosclerosis. Previous studies indicated that the risk factors of BAC partly overlap with those of cardiovascular disease (CVD), and the presence of BAC is associated with prevalent and incident CVD. This suggests that medial arterial calcification might contribute to CVD through a pathway distinct from the intimal atherosclerotic process. A recent study showed that the presence and severity of BAC are associated with the presence of coronary artery calcification or plaques on coronary computed tomography angiography in asymptomatic women aged more than 40 years. In addition, BAC provided an independent and incremental predictive value over conventional risk factors. Given that population-based mammography screening is currently recommended in asymptomatic women, the evaluation of BAC may be helpful in identifying high-risk women without additional cost or radiation exposure.
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Affiliation(s)
- Jung-Won Suh
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Korea
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Radiology, Seoul National University College of Medicine, Seongnam, Korea
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Handy CE, Quispe R, Pinto X, Blaha MJ, Blumenthal RS, Michos ED, Lima JA, Guallar E, Ryu S, Cho J, Kaye JA, Comin-Colet J, Corbella X, Cainzos-Achirica M. Synergistic Opportunities in the Interplay Between Cancer Screening and Cardiovascular Disease Risk Assessment. Circulation 2018; 138:727-734. [DOI: 10.1161/circulationaha.118.035516] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Catherine E. Handy
- Sidney Kimmel Comprehensive Cancer Center (C.E.H.)
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
| | - Renato Quispe
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
- Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY (R.Q.)
| | - Xavier Pinto
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, Barcelona, Spain (X.P.)
| | - Michael J. Blaha
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (M.J.B., E.D.M., E.G., J.C.)
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
| | - Erin D. Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (M.J.B., E.D.M., E.G., J.C.)
- Welch Center for Prevention, Epidemiology, and Clinical Research (E.D.M., E.G.), Johns Hopkins University, Baltimore, MD
| | - Joao A.C. Lima
- Division of Cardiovascular Imaging (J.A.C.L.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (M.J.B., E.D.M., E.G., J.C.)
- Welch Center for Prevention, Epidemiology, and Clinical Research (E.D.M., E.G.), Johns Hopkins University, Baltimore, MD
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center (S.R., J.C.)
- Department of Occupational and Environmental Medicine (S.R.)
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (S.R.)
| | - Juhee Cho
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (M.J.B., E.D.M., E.G., J.C.)
- Center for Cohort Studies, Total Healthcare Center (S.R., J.C.)
- Kangbuk Samsung Hospital, and Center for Clinical Epidemiology, Samsung Medical Center (J.C.), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - James A. Kaye
- Research Triangle Institute Health Solutions, Pharmacoepidemiology and Risk Management, Waltham, MA and Barcelona, Spain (J.A.K., M.C.-A.)
| | - Josep Comin-Colet
- Department of Cardiology, Bellvitge University Hospital and Bellvitge Biomedical Research Institute (Institut d’Investigació Biomèdica de Bellvitge), Barcelona, Spain (J.C.-C., M.C.-A.)
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain (J.C.-C.)
| | - Xavier Corbella
- Department of Internal Medicine, Bellvitge University Hospital, Barcelona, Spain (X.C.)
- Hestia Chair in Integrated Health and Social Care, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain (X.C.)
| | - Miguel Cainzos-Achirica
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology (C.E.H., R.Q., M.J.B., R.S.B., E.D.M., M.C.-A.)
- Research Triangle Institute Health Solutions, Pharmacoepidemiology and Risk Management, Waltham, MA and Barcelona, Spain (J.A.K., M.C.-A.)
- Department of Cardiology, Bellvitge University Hospital and Bellvitge Biomedical Research Institute (Institut d’Investigació Biomèdica de Bellvitge), Barcelona, Spain (J.C.-C., M.C.-A.)
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Calcification Patterns in Papillary Thyroid Carcinoma are Associated with Changes in Thyroid Hormones and Coronary Artery Calcification. J Clin Med 2018; 7:jcm7080183. [PMID: 30049993 PMCID: PMC6111282 DOI: 10.3390/jcm7080183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022] Open
Abstract
Recent studies suggested that a lower serum thyroid hormone level is associated with more vascular calcification. However, it has been rarely evaluated whether lower thyroid hormone levels affect the calcification of thyroid cancer and there is a relationship between calcification patterns of papillary thyroid carcinoma (PTC) and coronary artery calcification (CAC). The study was divided into two groups: First, we retrospectively reviewed 182 PTC patients and examined the correlation between PTC calcification patterns and CAC by coronary computed tomography (CT). Second, the correlation between the calcification pattern of PTC and thyroid hormone concentration was investigated (n = 354). The calcification pattern of PTC was evaluated by thyroid ultrasonography and classified into four groups: no-calcification, microcalcification, macrocalcification, and mixed-calcification. In PTC patients with microcalcification and mixed calcification, more CAC was observed and coronary calcium score (CCS) was higher. Lower free T4 and higher thyroid-stimulating hormone (TSH) levels were associated with microcalcification and mixed calcification, not with macrocalcification and no calcification. PTC with microcalcification and mixed calcification showed more aggressive phenotypes like lymph node metastasis and more advanced TNM (tumor, node, and metastasis) stage than those with no calcification and macrocalcification. Calcification patterns of PTC showed close association with thyroid hormone levels and CAC. Further research is needed to determine how these findings are related to cardiovascular risk and disease-specific mortality.
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Ružičić D, Dobrić M, Vuković M, Hrnčić D, Đorđević S, Ružičić M, Aleksandrić S, Đorđević-Dikić A, Beleslin B. Novel Assessment Tool For Coronary Artery Disease Severity During Screening Mammography. Health Care Women Int 2018; 39:1075-1089. [PMID: 29648938 DOI: 10.1080/07399332.2018.1463226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Breast arterial calcifications (BACs) are common findings on mammography which are associated with an increased risk of the coronary artery disease (CAD). Our aim in the current study was to design measurement instruments of CAD prediction, with or without BACs, and its discriminatory validity in the diagnosis of CAD (expressed by Syntax score) in women. This was observational, prospective study in the women cohort which underwent mammography and angiography. In this study we have demonstrated that the total 'The Breast Arterial Calcification and Coronary Artery Disease Scale' (BACCADS) was good additional diagnostic tool for detection of patients with severe CAD.
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Affiliation(s)
- Dušan Ružičić
- a General Hospital Valjevo, Department of Cardiology and Invasive Cardiology
| | - Milan Dobrić
- b Cardiology Clinic , Clinical Center of Serbia, Faculty of Medicine, University of Belgrade
| | - Mira Vuković
- a General Hospital Valjevo, Department of Cardiology and Invasive Cardiology
| | - Dragan Hrnčić
- d Institute of Medical Physiology "Richard Burian", Faculty of Medicine, University of Belgrade
| | | | - Milijana Ružičić
- a General Hospital Valjevo, Department of Cardiology and Invasive Cardiology
| | - Srđan Aleksandrić
- b Cardiology Clinic , Clinical Center of Serbia, Faculty of Medicine, University of Belgrade
| | - Ana Đorđević-Dikić
- b Cardiology Clinic , Clinical Center of Serbia, Faculty of Medicine, University of Belgrade
| | - Branko Beleslin
- b Cardiology Clinic , Clinical Center of Serbia, Faculty of Medicine, University of Belgrade
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20
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Iribarren C, Sanchez G, Husson G, Levine-Hall T, Quesenberry C, Sam DL, Maier J, Chaudhary RS, Patel M, Sadeghi B, Javan H, Cho HM, Ding H, Molloi S. MultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease: cohort recruitment and baseline characteristics. Ann Epidemiol 2018; 28:41-47.e12. [DOI: 10.1016/j.annepidem.2017.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/14/2017] [Accepted: 11/27/2017] [Indexed: 12/18/2022]
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21
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Ružičić D, Dobrić M, Vuković M, Hrnčić D, Đorđević S, Ružičić M, Aleksandrić S, Đorđević-Dikić A, Beleslin B. The correlation of SYNTAX score by coronary angiography with breast arterial calcification by digital mammography. Clin Radiol 2017; 73:454-459. [PMID: 29292048 DOI: 10.1016/j.crad.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/21/2017] [Accepted: 11/30/2017] [Indexed: 01/08/2023]
Abstract
AIM To evaluate the hypothesis that breast arterial calcification (BAC) may predict coronary artery disease (CAD) severity. MATERIALS AND METHODS The study comprised 102 women >45 years (mean age 62±8 years) referred for digital mammography after coronary angiography. BAC was assessed using the Likert scale and CAD severity was assessed using the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery trial) score. RESULTS In comparison to the low SYNTAX score group (≤22) patients with a intermediate-to-high SYNTAX score (>22) were older (p=0.001), they more often had hypercholesterolaemia (p<0.001), diabetes (p=0.021), and a history of smoking (p=0.048). They also had a statistically higher level of fasting blood glucose (p<0.001), glycated haemoglobin (HbA1C; p<0.001), triglycerides (p=0.002), fibrinogen (p=0.001), whereas high-density lipoprotein (HDLc) was lower than in the group with a SYNTAX score ≤22 (p=0.005). BAC was significantly higher in patients with a SYNTAX score >22 (p<0.001). At multivariate analysis, BAC (odds ratio [OR] 34.24, 95% confidence interval [CI]: 8.05-145.7, p<0.001), hypercholesterolaemia (OR 22.65, 95% CI: 4.18-122.81, p<0.001) and fibrinogen (OR 2.55, 95% CI: 1.28-5.07, p=0.008) were independent predictive factors for patients with intermediate-to-high SYNTAX score. CONCLUSIONS In women >45 years, there was a significant correlation between the severity of CAD as evaluated by the SYNTAX score and BAC as evaluated by the Likert scale. BAC, hypercholesterolaemia, and fibrinogen may be used as an additional diagnostic tool to predict the presence and severity of CAD.
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Affiliation(s)
- D Ružičić
- General Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Street Sinđelićeva 62, 14000 Valjevo, Serbia.
| | - M Dobrić
- Cardiology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Street Pasterova 2, 11000 Belgrade, Serbia
| | - M Vuković
- General Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Street Sinđelićeva 62, 14000 Valjevo, Serbia
| | - D Hrnčić
- Institute of Medical Physiology "Richard Burian", Faculty of Medicine, University of Belgrade, Street Višegradska 26, 11000, Belgrade, Serbia
| | - S Đorđević
- General Hospital Valjevo, Department of Radiology, Street Sinđelićeva 62, 14000 Valjevo, Serbia
| | - M Ružičić
- General Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Street Sinđelićeva 62, 14000 Valjevo, Serbia
| | - S Aleksandrić
- Cardiology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Street Pasterova 2, 11000 Belgrade, Serbia
| | - A Đorđević-Dikić
- Cardiology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Street Pasterova 2, 11000 Belgrade, Serbia
| | - B Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Street Pasterova 2, 11000 Belgrade, Serbia
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22
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Kelly BS, ScanlON E, Heneghan H, Redmond CE, Healy GM, Mc Dermott E, Heffernan EJ, Prichard R, Mc Nally S. Breast Arterial Calcification on screening mammography can predict significant Coronary Artery Disease in women. Clin Imaging 2017; 49:48-53. [PMID: 29127877 DOI: 10.1016/j.clinimag.2017.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/15/2017] [Accepted: 10/30/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Breast Arterial Calcification (BAC) on digital mammography has been associated with an increased risk of Coronary Artery Disease (CAD). We aimed to investigate the association of BAC with findings on Coronary Computed Tomography Angiography (CCTA) within a cohort of women from the national breast screening program. METHODS Symptomatic women (chest pain) aged between 50 and 65 who underwent a CCTA and who also had a screening mammography between 2014 and 2015 were recorded. BAC and CAD-RADS™: Coronary Artery Disease-Reporting and Data System were scored by separate blinded specialist radiologists. Cardiac risk factors were recorded. Patients' cardiac follow up (with Exercise Stress Test, Percutaneous Coronary Intervention or echocardiography) and cardio-protective medications were also documented. RESULTS 219 eligible women underwent a CCTA. Of these, 104 patients also underwent digital mammography. Using standard linear regression BAC was identified as a significant predictor of CAD-RADs ≥3 disease. Using binomial logistic regression, BAC remained associated with CAD-RADs ≥3 (p=0.023). A significantly higher proportion of patients with BAC >1 were on cardio-protective medications (p=0.041) and had medications initiated or changed, or had further cardiac investigation (p=0.037 and p=0.019, respectively) than those with no BAC, after a mean follow-up of 20.6 (range 15-27) months. CONCLUSION BAC diagnosed on 2 yearly screening mammography predicts CAD-RADs ≥3 disease in symptomatic patients.
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Affiliation(s)
- Brendan S Kelly
- Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland; Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - Emer ScanlON
- School of Medicine and Medical Science, UCD, Belfield D4, Ireland
| | - Helen Heneghan
- Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ciaran E Redmond
- Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland
| | - Gerard M Healy
- Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland
| | - Enda Mc Dermott
- Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Eric J Heffernan
- Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland
| | - Ruth Prichard
- Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Sorcha Mc Nally
- Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland; Breast Check, St Vincent's Healthcare Group, Elm Park Dublin 4, Ireland
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Adibi A, Rabani F, Hovsepian S. Bone Density in Postmenopausal Women with or without Breast Arterial Calcification. Adv Biomed Res 2017; 6:36. [PMID: 28516070 PMCID: PMC5385701 DOI: 10.4103/2277-9175.203161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Identification of osteoporosis in women in order to prevent its related morbidity and mortality is considered a priority. Routine mammography is performed on all menopausal women as a screening tool. Determination of the relation between breast arterial calcification (BAC) on mammography and the bone density of this high-risk population could help us to determine those with osteoporosis. The aim of this study was to investigate the mentioned probable relation between BAC and osteoporosis. MATERIALS AND METHODS In this cross-sectional study, menopausal women referred for annual screening mammography were enrolled. According to the results of mammography, they were classified into two groups: menopausal women with and without calcification of breast arteries. The selected women were referred for bone mineral density (BMD) evaluation by dual-energy x-ray absorptiometry (DXA). The results of BMD were compared between the two studied groups. RESULTS In this study, BMD was measured in 43 and 45 menopausal women with and without BAC, respectively. After age adjustment the difference between BMD measurements were not statistically significantly different (P > 0.05). There was a significant negative correlation between age and lumbar (P = 0.002, r = -0.42) and hip bone (P = 0.000, r = -0.67) density in menopausal women with BAC. CONCLUSION The results of the current study indicated that there was no significant relationship between BAC and BMD in our studied population, but it seems that increasing age has an important role in both developing BAC and reducing BMD. For obtaining more conclusive results, further studies with larger sample sizes and considering the severity of BAC is recommended.
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Affiliation(s)
- Atoosa Adibi
- From the Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farnaz Rabani
- From the Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Silva Hovsepian
- Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Yıldız C, Yıldız A, Karakurt A. Relationship between epicardial fat tissue thickness and breast arterial calcifications in premenopausal women. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2016. [DOI: 10.1016/j.ijcac.2016.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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25
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Zuin M, Rigatelli G, Scaranello F, Ribecco SG, Picariello C, Zuliani G, Faggian G, Zonzin P, Roncon L. Breast arterial calcifications on mammography and coronary artery disease: A new screening tool for cardiovascular disease? Int J Cardiol 2016; 220:310-1. [PMID: 27393837 DOI: 10.1016/j.ijcard.2016.06.266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Marco Zuin
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy; Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Gianluca Rigatelli
- Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
| | - Fiorenzo Scaranello
- Department of Radiology, Santa Maria della Misericordia Hospital Rovigo, Italy
| | | | - Claudio Picariello
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Giovanni Zuliani
- Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy
| | | | - Pietro Zonzin
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Loris Roncon
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy.
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26
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Chadashvili T, Litmanovich D, Hall F, Slanetz PJ. Do breast arterial calcifications on mammography predict elevated risk of coronary artery disease? Eur J Radiol 2016; 85:1121-4. [DOI: 10.1016/j.ejrad.2016.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
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27
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Recognizing Breast Arterial Calcification as Atherosclerotic CVD Risk Equivalent. JACC Cardiovasc Imaging 2016; 9:361-3. [DOI: 10.1016/j.jcmg.2015.09.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 09/17/2015] [Indexed: 11/21/2022]
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28
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Karm D, Marks DS, Wein M, Kong AL. Benign Arterial Calcification on Screening Mammogram: A Marker for Coronary Artery Disease? J Womens Health (Larchmt) 2015; 24:795-800. [DOI: 10.1089/jwh.2014.4905] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Deborah Karm
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David S. Marks
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Melissa Wein
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Amanda L. Kong
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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29
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Margolies LR, Salvatore MM, Hecht HS, Yip R, Yankelevitz DF, Henschke CI. WITHDRAWN: Digital breast arterial calcium score is predictive of coronary calcium score. Clin Imaging 2015:S0899-7071(15)00060-1. [PMID: 25861880 DOI: 10.1016/j.clinimag.2015.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/22/2015] [Indexed: 12/01/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
| | - Mary M Salvatore
- Department of Radiology, Icahn School of Medicine at Mount Sinai
| | - Harvey S Hecht
- Department of Internal Medicine, Cardiology, Icahn School of Medicine at Mount Sinai
| | - Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai
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30
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Hendriks EJE, de Jong PA, van der Graaf Y, Mali WPTM, van der Schouw YT, Beulens JWJ. Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis 2014; 239:11-20. [PMID: 25568948 DOI: 10.1016/j.atherosclerosis.2014.12.035] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/08/2014] [Accepted: 12/16/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Breast arterial calcifications (BAC), regularly observed at mammography, are medial calcifications and as such an expression of arteriosclerosis. Our objective was to evaluate and summarize the available evidence on the associations of BAC with cardiovascular risk factors and cardiovascular risk. METHODS A systematic literature review and meta-analysis were conducted. Embase and PubMed databases were searched. After critical appraisal, odds ratios were extracted from studies of moderate or good quality that examined risk factors for BAC or associations of BAC with cardiovascular disease. Random effects model meta-analyses were used to calculate pooled odds ratios and 95% confidence intervals (95%CIs). RESULTS BAC prevalence is around 12.7% among women in breast cancer screening programs. Increasing age (pooled OR 2.98 [95%CI 2.31-3.85] for every 10 years), diabetes (pooled OR: 1.88 [95%CI 1.36-2.59]) and parity as opposed to nulliparity (pooled OR 3.43 [95%CI 2.23-5.27]) are associated with higher BAC prevalence. Smoking is associated with lower BAC prevalence (pooled OR 0.48 [95%CI 0.39-0.60]). No associations were found with hypertension, obesity or dyslipidemia. Although longitudinal studies (n = 3) were scarce, BAC appear to be associated with an increased risk of cardiovascular disease events (adjusted hazard ratios for coronary heart disease ranging from 1.32 [95%CI 1.08-1.60] to 1.44 [95%CI1.02-2.05]). CONCLUSION BAC appear to be associated with an increased risk of cardiovascular disease events, while only being associated with some of the known cardiovascular risk factors, illustrating that medial arterial calcification might contribute to cardiovascular disease through a pathway distinct from the intimal atherosclerotic process.
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Affiliation(s)
- Eva J E Hendriks
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem P Th M Mali
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joline W J Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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31
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Takx RAP, Išgum I, Willemink MJ, van der Graaf Y, de Koning HJ, Vliegenthart R, Oudkerk M, Leiner T, de Jong PA. Quantification of coronary artery calcium in nongated CT to predict cardiovascular events in male lung cancer screening participants: results of the NELSON study. J Cardiovasc Comput Tomogr 2014; 9:50-7. [PMID: 25533223 DOI: 10.1016/j.jcct.2014.11.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 09/28/2014] [Accepted: 11/08/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the incremental prognostic value of the number and maximum volume of coronary artery calcifications over modified Agatston score strata, age, pack-years, and smoking status for predicting cardiovascular events. METHODS A total of 3559 male current and former smokers received a CT examination for lung cancer screening. Smoking characteristics, patient demographics, and physician-diagnosed cardiovascular events were collected. Images were acquired without electrocardiography gating on 16-slice CT scanners. The association between the presence of both fatal and nonfatal cardiovascular events and the predictors was quantified using Cox proportional hazard analysis. RESULTS Median follow-up period was 2.9 years. Incident cardiovascular events occurred in 186 participants. Adjusted hazard ratios for modified Agatston score strata of 1 to 10, 11 to 100, 101 to 400, and >400 were 3.39 (95% confidence interval [CI], 1.20-9.59), 6.52 (95% CI, 2.73-15.60), 6.58 (95% CI, 2.75-15.78), and 12.58 (95% CI, 5.42-29.16), respectively. Moreover, comparing the models with and without modified Agatston score strata to the model with age, pack-years, and smoking status yielded a significantly better net reclassification improvement (NRI; 27.3%; P < .0001). Adding the number of calcifications to the model with age, pack-years, smoking status, and modified Agatston score strata resulted in a slightly better NRI (1.68%; P = .0490) with a hazard ratio of 1.13 (95% CI, 1.05-1.21) per 10 calcifications. The incremental prognostic information contained in the volume of the largest calcification was not statistically significant (NRI, 0.14%; P = .3458). CONCLUSION Cardiovascular event rate increased with higher numbers of calcified lesions. The number but not maximum volume of calcifications has independent, although minimal, prognostic value over age, pack-years, smoking status, and modified Agatston score strata in our population.
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Affiliation(s)
- Richard A P Takx
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands.
| | - Ivana Išgum
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martin J Willemink
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rozemarijn Vliegenthart
- Center for Medical Imaging-North East Netherlands, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Matthijs Oudkerk
- Center for Medical Imaging-North East Netherlands, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
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32
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Nicoll R, Henein MY. The predictive value of arterial and valvular calcification for mortality and cardiovascular events. INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VESSELS 2014; 3:1-5. [PMID: 29450162 PMCID: PMC5801264 DOI: 10.1016/j.ijchv.2014.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/01/2014] [Indexed: 11/16/2022]
Abstract
A review of the predictive ability of arterial and valvular calcification has shown an additive effect of calcification in more than 1 location in predicting mortality and coronary heart disease, with mitral annual calcification being a particularly strong predictor. In individual arteries and valves there is a clear association between calcification presence, extent and progression and future cardiovascular events and mortality in asymptomatic, symptomatic and high risk patients, although adjustment for calcification in other arterial beds generally renders associations non-significant. Furthermore, in acute coronary syndrome, culprit plaque is normally not calcified. This would tend to reduce the validity of calcification as a predictor and suggest that the association with cardiovascular events and mortality may not be causal. The association with stroke is less clear; carotid and intracranial artery calcification show little predictive ability, with symptomatic plaques tending to be uncalcified.
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Affiliation(s)
- Rachel Nicoll
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, Umea, Sweden.,Canterbury Christ Church University, Kent , UK
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, Umea, Sweden.,Canterbury Christ Church University, Kent , UK
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Yildiz S, Toprak H, Aydin S, Bilgin M, Oktay V, Abaci O, Kocas C. The association of breast arterial calcification and metabolic syndrome. Clinics (Sao Paulo) 2014; 69:841-6. [PMID: 25627997 PMCID: PMC4286665 DOI: 10.6061/clinics/2014(12)09] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/23/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We investigated the relationship between metabolic syndrome and breast arterial calcification detected via mammography in a cohort of postmenopausal subjects. METHODS Among 837 patients referred to our radiology department for mammographic screening, 310 postmenopausal females (105 patients with and 205 patients without breast arterial calcification) aged 40 to 73 (mean 55.9 ± 8.4) years were included in this study. The groups were compared with respect to clinical characteristics and metabolic syndrome criteria. Univariate and multivariate analyses identified the factors related to breast arterial calcification. RESULTS Age, postmenopausal duration and the frequencies of diabetes mellitus, hypertension and metabolic syndrome were significantly higher in the subjects with breast arterial calcification than in those without (p<0.05). Multivariate analysis indicated that age (OR=1.3, 95% CI=1.1-1.6, p=0.001) and metabolic syndrome (OR=4.0, 95% CI=1.5-10.4, p=0.005) were independent predictors of breast arterial calcification detected via mammography. The independent predictors among the features of metabolic syndrome were low levels of high-density lipoproteins (OR=8.1, 95% CI=1.0-64.0, p=0.047) and high blood pressure (OR=8.7, 95% CI=1.5-49.7, p=0.014). CONCLUSIONS The likelihood of mammographic detection of breast arterial calcification increases with age and in the presence of hypertension or metabolic syndrome. For patients undergoing screening mammography who present with breast arterial calcification, the possibility of metabolic syndrome should be considered. These patients should be informed of their cardiovascular risk factors and counseled on appropriate lifestyle changes.
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Affiliation(s)
- Seyma Yildiz
- Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Huseyin Toprak
- Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Sinem Aydin
- Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Mehmet Bilgin
- Bezmialem Vakif University, Department of Radiology, Istanbul, Turkey
| | - Veysel Oktay
- Istanbul Universty, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
| | - Okay Abaci
- Istanbul Universty, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
| | - Cuneyt Kocas
- Istanbul Universty, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
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Loberant N, Salamon V, Carmi N, Chernihovsky A. Prevalence and Degree of Breast Arterial Calcifications on Mammography: A Cross-sectional Analysis. J Clin Imaging Sci 2013; 3:36. [PMID: 24228205 PMCID: PMC3814575 DOI: 10.4103/2156-7514.119013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/21/2013] [Indexed: 11/16/2022] Open
Abstract
Objectives: The purpose of this study is to establish a database including prevalence and degree of breast arterial calcifications (BAC) in our population of women presenting for mammography. Materials and Methods: The mammograms of 1786 women over the age of 40 years were examined for the presence and degree of BAC. Statistical analysis was performed to correlate patient's age and ethnic origin with the presence and degree of BAC. Results: There was statistically significant and strong correlation between the patient's age and presence of BAC. There was also a less strong yet statistically significant correlation between patient age and degree of BAC. Regression analysis showed the likelihood of BAC at various ages. The prevalence of BAC is only 2% of women under 50 years of age; the prevalence of Grade 2-3 BAC is only 1% in women under 60 years of age. Conclusion: There is a predictable increase with age in both prevalence and degree of BAC in women. The presence of high degree BAC in women under 60 years of age or any BAC in women under 50 years of age is unusual.
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Affiliation(s)
- Norman Loberant
- Department of Radiology, Western Galilee Hospital, Nahariya, Israel ; Bar Ilan Faculty of Medicine in the Galilee, Safed, Israel
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