The relationship between coronary artery calcification and myocardial perfusion in asymptomatic women

Fathala, Ahmed; Amer, Ali Al; Shukri, M. A.; Abouzied, Mohei; Al-Sugair, Abdulaziz

doi:10.5144/0256-4947.2012.378

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…Table 2 summarizes current evidence of the association between BAC and coronary atherosclerosis. 3) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 24) 25) Initially, several studies examined the relationship of BAC with coronary atherosclerosis based on a coronary angiography diagnosis. The results were inconsistent across the studies and a 5-study meta-analysis by Abi Rafeh et al 26) , including nearly 1000 women, demonstrated that patients with BAC had a 1.59-fold increased risk of CAD by angiography.…”

Section: Association Of Bac and Coronary Atherosclerosismentioning

confidence: 99%

Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease

Suh

Yun

2018

J Cardiovasc Imaging

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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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Section: Association Of Bac and Coronary Atherosclerosismentioning

confidence: 99%

Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease

Suh

Yun

2018

J Cardiovasc Imaging

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“…In general, the role of CAC in CAD is not yet investigated in the region. A previous study in Saudi Arabia conducted by Fathala et al, 23 indicated a strong association between severity of CAC and ischemic myocardial perfusion in women. Asymptomatic women with one or more CAD risk factors and moderate to severe CAC had more than 50% of ischemic myocardial perfusion.…”

Section: Discussionmentioning

confidence: 87%

Coronary artery calcium score in high-risk asymptomatic women in Saudi Arabia

Fathala

Alreshoodi

Rujaib

et al. 2015

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVECoronary artery calcification (CAC) is indicated by calcium deposits in the coronary artery wall. Calcification is a component of atherosclerosis and coronary artery disease. Currently, there are no data on calcification in Saudi women at high risk of coronary artery disease. The aim of this study was to investigate the prevalence and percentiles of CAC score in high-risk asymptotic women in Saudi Arabia with comparison of age-specific CAC percentiles derived from la arge population-based published study in the United States.DESIGN AND SETTINGRetrospective analysis of CAC scores (CACS) at a single tertiary care center.METHODSBetween January 2011 and April 2015, women referred for CAC screening because of the presence of one or more CAD risk factors were enrolled in the study. CT scans were interpreted by an experienced radiographic technologist, and confirmed by a radiologist.RESULTSThe study sample consisted of 918 women, mean (SD) age of 55 (11) years. All patients were asymptomatic and referred by their primary care physician or cardiologist for CAC screening because presence of one or more CAD risks factors. CAD risk factors included diabetes, hypertension, hypercholesterolemia, family history of CAD, and obesity. Baseline CAD risk factors were remarkably higher than in the US comparator group. CACS for 25th, 50th, 75th, and 90th percentiles were calculated. The 75th and 90th CACS percentiles in Saudi women were significantly higher than the US percentiles. Age and diabetes are the most independent predictor of severity of CAC.LIMITATIONSA potential bias due to sample collection because data was from a single tertiary care center, the study was retrospective and the sample size was small.CONCLUSIONThere are significantly higher CACS percentiles in Saudi women compared with international data. Application of available published percentiles to a local population is not applicable and underestimates the severity of subclinical atherosclerosis. A large local population-based study is warranted to establish local CACS percentiles for a better understanding CAD screening, diagnosis, and treatment.

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“…Fathala and coworkers, in a retrospective study of 101 Saudi women, aged a mean (SD) of 56 (11) years, without a history of CAD, reported that moderate to severe CAC scores were associated with ischemic MPI in more than 50%of asymptomatic women with two or more CAD risk factors; a calcium score of 0 was rarely associated with an abnormal MPI. 26 In another retrospective study by the same author, 157 patients with known cancer who underwent positron emission tomography/computed tomography (PET/CT) for cancer management and MPI SPECT for preoperative cardiac risk stratification without known CAD, the author concluded that visual detection of CAC in the CT component of PET/CT is a strong predictor of MPI results. The presence of CAC was associated with a high likelihood of abnormal MPS and an absence of CAC was rarely associated with abnormal MPI.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of coronary artery calcification in Saudi patients with normal myocardial perfusion

Fathala

Bukhari

Shoukri

et al. 2017

Annals of Saudi Medicine

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BACKGROUNDNormal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has a high negative predictive value for ischemic heart disease. Thus, the presence of subclinical coronary atherosclerosis detected by coronary artery calcification (CAC) score in patients who have undergone SPECT MPI is unknown.OBJECTIVESDetermine the prevalence of coronary artery calcification (CAC) in patients with normal SPECT MPI and examine the association of CAC with conventional coronary artery disease (CAD) risk factors.DESIGNCross-sectional analytical study using medical records from February 2010 to April 2016.SETTINGSSingle tertiary-care center.PATIENTS AND METHODSWe studied patients referred from the outpatient clinical services for clinically indicated noninvasive CAD diagnosis with MPI SPECT. CAC scoring was subsequently performed within 3 months after a normal MPI. We excluded patients with chest pain or decompensated heart failure or patients with a history of CAD. The study population was divided into three groups: patients with a CAC score of 0, a CAC score from 1 to 300, and a CAC score more than 300. The groups were analyzed by age and other demographic and clinical characteristics.MAIN OUTCOME MEASURE(S)Prevalence of CAC in patients with normal MPI.RESULTSThe prevalence of CAC was 55% (n=114) in 207 patients with a mean (SD) age of 57.1 (10.4) years. Twelve percent had severe coronary atherosclerosis (CAC score >300). All patients had a normal MPI SPECT. CAC scores were 0 for 93 patients (45%), 1 to 300 for 89 (43%), and more than 300 for 24 (12%). There was a strong association between CAC score and age (P<.0001), male sex (P<.0001), and diabetes mellitus (P=.042), but no association between CAC score and hypertension (P=.153), family history of CAD (P=.23), obesity (P=.31), hypercholesterolemia (P=.071), or smoking (P=.308).CONCLUSIONSThe prevalence of CAC is high in this study population of patients with normal SPECT MPI. Age, male sex and diabetes were risk factors associated with CAC.LIMITATIONSSingle center and small study population.

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The relationship between coronary artery calcification and myocardial perfusion in asymptomatic women

Cited by 6 publications

References 30 publications

Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease

Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease

Coronary artery calcium score in high-risk asymptomatic women in Saudi Arabia

High prevalence of coronary artery calcification in Saudi patients with normal myocardial perfusion

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