Coronary Calcification in Adults with Turner Syndrome

PURPOSE: Adults with Turner syndrome (TS) have an increased predisposition to ischemic heart disease. The quantitative relationship between coronary atherosclerosis and TS has yet to be established. METHODS: 128 females (62 with TS) participated in this prospective study. Coronary computed tomography angiography (CTA) was performed to measure coronary calcified plaque burden, and prevalent non-calcified plaque burden. Regression analysis was used to study the effects of TS and traditional cardiovascular disease risk factors on coronary plaque burden. RESULTS: Adults with TS were 63% more likely to have coronary calcifications than controls (odds ratio (OR) 1.63, 95% confidence interval (CI): 1.02, 2.61, P=0.04), with an age cutoff of 51.7 years for a probability of >50% for the presence of coronary calcifications when compared to 55.7 years in female controls. The average age of TS and calcified plaques was significantly lower than controls (51.5±8.9 years vs. 60.5 ±7.0 years, P<0.001). Age increased the likelihood of coronary calcifications by 13% per year (OR 1.13, CI 95%: 1.07–1.19, P<0.001). CONCLUSION: This study demonstrates a higher prevalence and earlier onset of calcified coronary plaques in TS. These findings have important implications for cardiovascular risk assessment and the management of patients with TS.