Does the absence of breast arterial calcification (BAC 0) rule out severe coronary artery disease? A computed tomography angiography study.

Autor:	Deeg J; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Swoboda M; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Bilgeri V; Department of Internal Medicine, Cardiology, Medical University Innsbruck, Austria., Lacaita PG; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Scharll Y; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Luger A; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Widmann G; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Gruber L; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria., Feuchtner GM; Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
Jazyk:	angličtina
Zdroj:	American journal of preventive cardiology [Am J Prev Cardiol] 2024 Aug 23; Vol. 19, pp. 100724. Date of Electronic Publication: 2024 Aug 23 (Print Publication: 2024).
DOI:	10.1016/j.ajpc.2024.100724
Abstrakt:	Background: Cardiovascular risk (CV)-stratification in females is challenging, and current models miss a high proportion at-risk. Breast arterial calcifications (BAC) are independent prognosticators, but their interaction with the coronary artery disease profile by computed tomography (CT) is controverse, and the role of BAC 0 unclear. Objective: to investigate the interaction of BAC with coronary CT outcomes (CAC score, coronary stenosis severity and high-risk plaque (HRP). Methods: Consecutive patients referred to mammography (MG) and coronary CTA for clinical indications within 1 year were included. Three different age groups were compared (<55 years;55-65 years;>65 years). Results: 443 patients were included. There were significant age differences for the prevalence of BAC 0 (p<0.001), BAC 0/CAC>300 AU (p=0.0023) and obstructive disease (>50% stenosis)(p=0.0048) but not for high-risk-plaque (HRP)(p=0.4905). High CAC (>300 AU) was present in only 0.82% of females with BAC 0 in less than 55 year, but significantly more often in those above 65 years (p=0.0004;OR=16.58:95% CI: 2.829-361.7) and 55 years with 12.1% and 8.4%. Obstructive coronary disease (>50% stenosis) in BAC 0 was present in 18.2%; with age-dependent differences (10.7% vs 14.7% vs 29.9%) (p=0.0003). The correlation between BAC, CAC and CADRADS was weak (r=0.246 and r=0.243, p<0.001). There was no association of BAC with HRP. Conclusion: BAC 0 rules out severe CAC >300AU in females <55 years only, but not in those above 55 years- with adherent implications for primary prevention. However, BAC 0 does not to rule out obstructive disease and high-risk plaques in symptomatic patients among all age groups. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Author(s).)
Databáze:	MEDLINE
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