| 김응주¹, 서홍석¹ , 용확석² , 나진오¹ , 박재형¹ , 최철웅¹ , 임홍의¹ , 김진원¹ , 나승운¹ , 박창규¹ , 오동주¹ , |
Background: Aortic calcification (AC) frequently coexists and has similar risk factors with coronary artery disease (CAD) and osteoporosis. We investigated the role of AC for CAD and bone density by a single measurement of 64-slice mutidetector coronary CT (MDCT).
Methods: We divided 558 consecutive subjects, who underwent MDCT, into CAD and non-CAD group according to the presence or absence of >50% luminal narrowing in at least one coronary artery. In two groups, we matched the dichotomized cardiovascular risk factors (age>60 years, sex, hypertension, diabetes, dyslipidemia, smoking). Finally 254 patients (65.0±8.6 years; M:F=136:118) were included in this study. Calcium scores in whole thoracic aorta were quantified with MDCT by means of Agaston score. We also determined the mean hounsfiled unit for unfractured vertebrae from T10-T12 and represented it as bone density.
Results: The prevalence of AC was significantly higher in CAD (n=121) compared to non-CAD (n=133) group (65.9% vs. 47.9%, p=0.005). CAD prevalence according to aortic Agaston score tertile was 42.2%, 53.0%, and 63.5%, respectively (p=0.014). The Odds ratio of the presence of AC for CAD was 1.95 (CI 1.01-3.76, p=0.047) in multivariate logistic regression model. The subjects with AC showed significantly lower bone density than without (114.8±41.6 vs. 160.6±43.2, p<0.001). The bone density according to aortic Agaston score tertile was 159.6±39.4, 133.3±45.0, and 104.7±42.5, respectively (p<0.001). Among those with AC, the correlation coefficient between (ln) Agaston score and bone density was -0.424 (p<0.001). The relationship between risk factors and bone density was assessed with multivariate linear regression. AC as well as age > 60 years and women showed significant inverse relation (for all, p<0.001) and other risk factors did not.
Conclusions: In a single measurement of MDCT, we demonstrated that AC was a significant independent risk factor for CAD and showed significant inverse relation with bone density. Our results support that arterial calcification, atherosclerosis and bone metabolism are interrelated and AC might be a useful subclinical surrogate marker for CAD and osteoporosis.
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