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Nguyen DL, Ren Y, Jones TM, Thomas SM, Lo JY, Grimm LJ, Gamagami E. Patient Characteristics Impact Performance of AI Algorithm in Interpreting Negative Screening Digital Breast Tomosynthesis Studies. Radiology 2024; 311:e232286. [PMID: 38771177 PMCID: PMC11140531 DOI: 10.1148/radiol.232286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/22/2024] [Accepted: 03/25/2024] [Indexed: 05/22/2024]
Abstract
Background Artificial intelligence (AI) is increasingly used to manage radiologists' workloads. The impact of patient characteristics on AI performance has not been well studied. Purpose To understand the impact of patient characteristics (race and ethnicity, age, and breast density) on the performance of an AI algorithm interpreting negative screening digital breast tomosynthesis (DBT) examinations. Materials and Methods This retrospective cohort study identified negative screening DBT examinations from an academic institution from January 1, 2016, to December 31, 2019. All examinations had 2 years of follow-up without a diagnosis of atypia or breast malignancy and were therefore considered true negatives. A subset of unique patients was randomly selected to provide a broad distribution of race and ethnicity. DBT studies in this final cohort were interpreted by a U.S. Food and Drug Administration-approved AI algorithm, which generated case scores (malignancy certainty) and risk scores (1-year subsequent malignancy risk) for each mammogram. Positive examinations were classified based on vendor-provided thresholds for both scores. Multivariable logistic regression was used to understand relationships between the scores and patient characteristics. Results A total of 4855 patients (median age, 54 years [IQR, 46-63 years]) were included: 27% (1316 of 4855) White, 26% (1261 of 4855) Black, 28% (1351 of 4855) Asian, and 19% (927 of 4855) Hispanic patients. False-positive case scores were significantly more likely in Black patients (odds ratio [OR] = 1.5 [95% CI: 1.2, 1.8]) and less likely in Asian patients (OR = 0.7 [95% CI: 0.5, 0.9]) compared with White patients, and more likely in older patients (71-80 years; OR = 1.9 [95% CI: 1.5, 2.5]) and less likely in younger patients (41-50 years; OR = 0.6 [95% CI: 0.5, 0.7]) compared with patients aged 51-60 years. False-positive risk scores were more likely in Black patients (OR = 1.5 [95% CI: 1.0, 2.0]), patients aged 61-70 years (OR = 3.5 [95% CI: 2.4, 5.1]), and patients with extremely dense breasts (OR = 2.8 [95% CI: 1.3, 5.8]) compared with White patients, patients aged 51-60 years, and patients with fatty density breasts, respectively. Conclusion Patient characteristics influenced the case and risk scores of a Food and Drug Administration-approved AI algorithm analyzing negative screening DBT examinations. © RSNA, 2024.
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Affiliation(s)
| | | | - Tyler M. Jones
- From the Department of Radiology, Duke University School of Medicine,
10 Duke Medicine Cir, Durham, NC 27710 (D.L.N., J.Y.L., L.J.G.); Pratt School of
Engineering (Y.R.) and Department of Biostatistics and Bioinformatics (T.M.J.,
S.M.T.), Duke University, Durham, NC; and iCAD, Nashua, NC (Y.R.)
| | - Samantha M. Thomas
- From the Department of Radiology, Duke University School of Medicine,
10 Duke Medicine Cir, Durham, NC 27710 (D.L.N., J.Y.L., L.J.G.); Pratt School of
Engineering (Y.R.) and Department of Biostatistics and Bioinformatics (T.M.J.,
S.M.T.), Duke University, Durham, NC; and iCAD, Nashua, NC (Y.R.)
| | - Joseph Y. Lo
- From the Department of Radiology, Duke University School of Medicine,
10 Duke Medicine Cir, Durham, NC 27710 (D.L.N., J.Y.L., L.J.G.); Pratt School of
Engineering (Y.R.) and Department of Biostatistics and Bioinformatics (T.M.J.,
S.M.T.), Duke University, Durham, NC; and iCAD, Nashua, NC (Y.R.)
| | - Lars J. Grimm
- From the Department of Radiology, Duke University School of Medicine,
10 Duke Medicine Cir, Durham, NC 27710 (D.L.N., J.Y.L., L.J.G.); Pratt School of
Engineering (Y.R.) and Department of Biostatistics and Bioinformatics (T.M.J.,
S.M.T.), Duke University, Durham, NC; and iCAD, Nashua, NC (Y.R.)
| | - Eileen Gamagami
- From the Department of Radiology, Duke University School of Medicine,
10 Duke Medicine Cir, Durham, NC 27710 (D.L.N., J.Y.L., L.J.G.); Pratt School of
Engineering (Y.R.) and Department of Biostatistics and Bioinformatics (T.M.J.,
S.M.T.), Duke University, Durham, NC; and iCAD, Nashua, NC (Y.R.)
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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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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Biomarkers in metabolic syndrome. Adv Clin Chem 2022; 111:101-156. [DOI: 10.1016/bs.acc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Yang SW, Yang HF, Chen YY, Chen WL. Unraveling the link between metabolic syndrome and abdominal aortic calcification. Nutr Metab Cardiovasc Dis 2021; 31:464-471. [PMID: 33223398 DOI: 10.1016/j.numecd.2020.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/03/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Over the last few decades, the prevalence of metabolic syndrome (MetS) has gradually increased. As we know, many prior studies have connected MetS with diabetes, coronary heart disease, and cardiovascular disease. Abdominal aortic calcification (AAC) is a good marker of morbidity and mortality of vascular disease, as its degree may be associated with the severity of coronary artery calcification and disease. The aim of this article is to investigate the connection between MetS and AAC. METHODS AND RESULTS This retrospective observational study included 2731 participants aged 58 years from the National Health and Nutrition Examination Survey (NHANES) (2013-2014). We used Dual-Energy X-ray Absorptiometry to define the degree of AAC. We defined MetS according to the National Cholesterol Education Program Adult Treatment Panel III definition. A total of 2731 participants with complete data were included for data analysis. In the fully adjusted model, an increase in the severity of AAC with the number of MetS components was still significant with βvalues of AAC Total 24 Score 0.498 (95% confidence interval (CI): 0.018,0.978), 1.016 (95% CI: 0.514,1.519) and 1.426 (95% CI: 0.916,1.937) respectively in 2, 3 and ≧ 4 components. Additionally, associations were observed between MetS components, including blood pressure, HDL and glucose with βvalues of AAC Total 24 Score 0.332(95% CI: 0.069, 0.595), 0.652(95% CI: 0.380, 0.925) and 0.534 (95% CI: 0.285, 0.783) after fully adjusted, respectively. CONCLUSION The results indicated that, in the US adult population, a greater number of components of MetS were significantly associated with AAC. Among the components of metabolic syndrome, the blood pressure, HDL and blood sugar were observed apparent association with AAC.
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Affiliation(s)
- Shih-Wei Yang
- Department of Orthopedic, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Hui-Fang Yang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Yuan-Yuei Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC; Department of Pathology, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan, ROC
| | - Wei-Liang Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.
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Is breast arterial calcification associated with coronary artery disease?-A systematic review and meta-analysis. PLoS One 2020; 15:e0236598. [PMID: 32722699 PMCID: PMC7386618 DOI: 10.1371/journal.pone.0236598] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is increasing evidence that breast arterial calcification (BAC), an incidental finding on 3-29% of mammograms, could be used to screen for coronary artery disease (CAD). We conducted a systematic review to assess the associations between BAC and CAD and its risk factors (hypertension, hypercholesterolemia, diabetes mellitus and smoking). METHODS AND FINDINGS MEDLINE and EMBASE databases and references of relevant papers were searched up to 18 February 2020 for English language studies that evaluated the associations of BAC and CAD and its risk factors. A single reviewer extracted all data and assessed study quality with verification by another independent reviewer, if required. Across 31 studies (n = 35,583; 3 longitudinal and 28 cross-sectional studies) that examined the association of BAC and CAD, the OR was 2.61 (95% CI 2.12-3.21; I2 = 71%). Sub-analysis of studies that graded BAC severity using the 4- (4 studies) or 12-point scale systems (3 studies) revealed an association with CAD and moderate-severe BAC (OR 4.83 (95%CI 1.50-15.54) and OR 2.95 (95%CI 1.49-5.84), respectively) but not mild BAC (OR 2.04 (95%CI 0.82-5.05) and OR 1.08 (95%CI 0.42-2.75), respectively). BAC was associated with hypertension (42 studies; n = 32,646; OR 1.80; 95% CI 1.47-2.21; I2 = 85%) and diabetes mellitus (51 studies; n = 53,464; OR 2.17; 95% CI 1.82-2.59; I2 = 75%) but not with hypercholesterolemia (OR 1.31; 95%CI 0.97-1.77; I2 = 67%). Smoking was inversely associated with BAC (35 studies; n = 40,002; OR 0.54; 95% CI 0.42-0.70; I2 = 83%). Studies mostly included symptomatic women. Marked heterogeneity existed and publication bias may be present. CONCLUSIONS BAC is associated with CAD, diabetes mellitus and hypertension and inversely associated with smoking. Whether BAC could screen for CAD cannot be determined from current published data due to the lack of larger prospective studies. A consensus approach to quantifying BAC may also facilitate further translation into clinical care. PROSPERO: CRD42020141644.
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Association of vascular calcification of breast with carotid intima media thickness. Pol J Radiol 2019; 84:e335-e339. [PMID: 31636768 PMCID: PMC6798773 DOI: 10.5114/pjr.2019.88064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/13/2019] [Indexed: 11/22/2022] Open
Abstract
Purpose To assess the relationship between breast arterial calcification (BAC) on mammography and carotid intima medial thickness (C-IMT) by comparing these patients with healthy control subjects. Material and methods The study included 100 women divided into two groups based on presence of BAC on mammography using the WIPRO GE – DMR PLUS mammography unit. The groups included 50 BAC(+) (case group) and 50 BAC(–) (control group). BAC is defined as two linear calcific deposits forming the rail-road track pattern, with ring-like appearance in cross section. Relevant previous clinical and surgical history was taken and C-IMT was measured using B-mode ultrasonography Aplio XG (Toshiba medical systems corp., Japan) using an 8-13 MHz linear transducer within 1 cm from the proximal and distal portion of the common carotid artery and the mean value was taken. Results All the participants included in this study were within the age group of 40-70 years. Mean age with BAC(+) was 59.18 ± 8.59 years and BAC(–) was 50.70 ± 7.93 years. Mean C-IMT in the BAC(+) group was 0.86 ± 0.21 mm vs. 0.71 ± 0.12 mm in the BAC(–) group. Chi-square test, independent t test and Spearman’s rho correlation to assess the association of the breast arterial calcification were performed. The study showed significant difference in mean C-IMT between two groups (p value < 0.001) when correlated with age, diabetes, hypertension, presence of BAC and history of surgery and drug intake. Conclusions BAC in mammography is independently associated with C-IMT. Furthermore, apart from age and menopausal status a statistically significant positive correlation with C-IMT was observed.
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Pathological Mineralization: The Potential of Mineralomics. MATERIALS 2019; 12:ma12193126. [PMID: 31557841 PMCID: PMC6804219 DOI: 10.3390/ma12193126] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Abstract
Pathological mineralization has been reported countless times in the literature and is a well-known phenomenon in the medical field for its connections to a wide range of diseases, including cancer, cardiovascular, and neurodegenerative diseases. The minerals involved in calcification, however, have not been directly studied as extensively as the organic components of each of the pathologies. These have been studied in isolation and, for most of them, physicochemical properties are hitherto not fully known. In a parallel development, materials science methods such as electron microscopy, spectroscopy, thermal analysis, and others have been used in biology mainly for the study of hard tissues and biomaterials and have only recently been incorporated in the study of other biological systems. This review connects a range of soft tissue diseases, including breast cancer, age-related macular degeneration, aortic valve stenosis, kidney stone diseases, and Fahr’s syndrome, all of which have been associated with mineralization processes. Furthermore, it describes how physicochemical material characterization methods have been used to provide new information on such pathologies. Here, we focus on diseases that are associated with calcium-composed minerals to discuss how understanding the properties of these minerals can provide new insights on their origins, considering that different conditions and biological features are required for each type of mineral to be formed. We show that mineralomics, or the study of the properties and roles of minerals, can provide information which will help to improve prevention methods against pathological mineral build-up, which in the cases of most of the diseases mentioned in this review, will ultimately lead to new prevention or treatment methods for the diseases. Importantly, this review aims to highlight that chemical composition alone cannot fully support conclusions drawn on the nature of these minerals.
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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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SOYLU Aİ, SOYLU K, AYDIN R, UZUNKAYA F, ASLAN K, POLAT AV. Calcification of breast artery as detected by mammography: association with coronary and aortic calcification. Turk J Med Sci 2019; 49:190-197. [PMID: 30764597 PMCID: PMC7350865 DOI: 10.3906/sag-1807-275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background/aim https://orcid.org/0000-0002-9740-3580 Materials and methods A total of 404 female patients above 40 years of age who, within a 6-month period, had undergone thoracic computed tomography and mammography for various reasons were screened retrospectively at our clinic. Mammographies were assessed for BAC and thoracic CT investigations were assessed for CAC and AC. Patients included in the study were scored as 0 (none), 1 (mild), 2 (moderate), or 3 (severe) depending on the number and shape of CAC, AC, and BAC lesions observed. Results Four hundred and four females were enrolled in the study. While BAC was detected in 123 patients, no BAC was observed in the other 281 patients. In the BAC-positive patients, the rates of CAC (45.5% vs. 19.9%, P < 0.001) and AC (67.5% vs. 32.4%, P < 0.001) were notably higher than in the BAC-negative patients. In addition, multivariate regression analysis detected the presence of BAC as an independent variable for both CAC and AC. Conclusion The presence of BAC appeared to be a significant risk factor for CAC and AC, and the BAC grade was considered an independent risk factor for CAC.
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Affiliation(s)
- Ayşegül İdil SOYLU
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Korhan SOYLU
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Ramazan AYDIN
- Clinic of Radiology, Kırıkkale Yüksek İhtisas Hospital, KırıkkaleTurkey
| | - Fatih UZUNKAYA
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Kerim ASLAN
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Ahmet Veysel POLAT
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
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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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Tabatabaei-Malazy O, Djalalinia S, Asayesh H, Shakori Y, Esmaeili Abdar M, Mansourian M, Mahdavi Gorabi A, Noroozi M, Qorbani M. Menopause and metabolic syndrome in the Middle East countries; a systematic review and meta-analysis study. J Diabetes Metab Disord 2018; 17:357-364. [PMID: 30918871 PMCID: PMC6405407 DOI: 10.1007/s40200-018-0375-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Metabolic syndrome (MetS) prevalence that is associated with increasing risk of diabetes and cardiovascular diseases (CVD) has accelerated with age. Since, menopause is known as a partial cause of CVD accelartion with againg among women, determining the prevalence of MetS is important in this condition. We aimed to assess critically the prevalence rate of MetS among menopaused women in the Middle East Countries in this systematic review meta-analysis study. METHODS & MATERIALS International webdata bases including Scopus, ISI web of Science and PubMed were systematically searched using Medical Subject Headings terms from January 2000 to February 2017. We included all cross-sectional conducted in the Middle East that reported prevalence of MetS in menopause status regardless of MetS definition. Quality assessment was considered for each included study. The pooled prevalence of MetS based on the Adult Treatment Panel III (ATP III) was estimated using random effect method due to between-study heterogeneity by STATA software, version 11.0 (StataCorp, USA). RESULTS Within 60 studies, 21 and 17 studies were included in qualitative synthesis and meta-analysis respectively. The prevalence of MetS among menopaused women was estimated 54.87% (95% CI: 53.76-55.97) in the Middle East countries. In sub-group analysis based on country the prevalence rate of MetS in Iran and Turkey was estimated 58.78% (95% CI: 57.54-60.02), and 39.02% (95% CI: 36.57-41.47), respectively. CONCLUSIONS MetS was highly prevalent as an alarming sign among menopaused women in the Middle East countries. Thus, it is an emergency requirement to promote healthy lifestyle. Also, early detection and treatment of women who reach menopause and are at great risk of developing MetS is necessary for prevention of diabetes and CVD in the region.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Yalda Shakori
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Esmaeili Abdar
- Social Determinants of Health Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, ehran University of Medical Sciences, Tehran, Iran
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13
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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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14
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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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15
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Ronzani FAT, Kirchmaier FM, Monteze NM, Magacho EJDC, Bastos MG, Fernandes NMDS. Routine mammography: an opportunity for the diagnosis of chronic degenerative diseases? A cross-sectional study. Radiol Bras 2017; 50:82-89. [PMID: 28428650 PMCID: PMC5396997 DOI: 10.1590/0100-3984.2015.0173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study was to evaluate breast arterial calcification (BAC)
detected on routine mammography, analyzing its association with chronic
degenerative disease. Materials and Methods This was a cross-sectional study involving women treated at a specialized
outpatient clinic for high-risk hypertension, diabetes, or chronic kidney
disease, as well as volunteers who participated in a study to validate a
method of screening for occult renal disease. A total of 312 patients
between 40 and 69 years of age, with no history of breast cancer, all of
whom had undergone routine mammography in the last two years, were included.
The mammograms were analyzed by researchers who were unaware of the risk
factors for BAC in each case. Results The mean age was 55.9 ± 7.4 years, and 64.3% of the patients were
white. The mean glomerular filtration rate was 41.87 ± 6.23
mL/min/1.73 m2. Seventy-one patients (22.8%) had BAC. We found
that BAC was associated with advanced age, hypertension, diabetes, chronic
kidney disease, and low glomerular filtration rate. In the multivariate
analysis, advanced age and diabetes continued to be associated with BAC. The
odds ratio for BAC was higher for all chronic diseases. Conclusion The association of BAC with advanced age, hypertension, diabetes, chronic
kidney disease, and low glomerular filtration rate should call the attention
of radiologists. Therefore, the presence of BAC should be reported, and
patients with BAC should be screened for those diseases.
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Affiliation(s)
- Flávio Augusto Teixeira Ronzani
- MSc, Assistant Professor in the Department of Clinical Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Filomena Maria Kirchmaier
- Nurse, Department of Clinical Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Nathália Mussi Monteze
- MD, Department of Clinical Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | | | - Marcus Gomes Bastos
- MD, PhD, Coordinator of the Interdisciplinary Center for Studies, Research, and Treatment in Nephrology, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
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