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Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study

AIM: To assess the prevalence of breast arterial calcification (BAC) in patients who also underwent routine surveillance mammography, and to determine the association with cardiovascular risk factors, coronary artery calcification, and coronary artery disease on coronary computed tomography angiogra...

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Autores principales: McLenachan, S., Camilleri, F., Smith, M., Newby, D.E., Williams, M.C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Scientific Publications Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512949/
https://www.ncbi.nlm.nih.gov/pubmed/30803814
http://dx.doi.org/10.1016/j.crad.2019.01.014
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author McLenachan, S.
Camilleri, F.
Smith, M.
Newby, D.E.
Williams, M.C.
author_facet McLenachan, S.
Camilleri, F.
Smith, M.
Newby, D.E.
Williams, M.C.
author_sort McLenachan, S.
collection PubMed
description AIM: To assess the prevalence of breast arterial calcification (BAC) in patients who also underwent routine surveillance mammography, and to determine the association with cardiovascular risk factors, coronary artery calcification, and coronary artery disease on coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Four hundred and five female participants were identified who had undergone CCTA and subsequent mammography in the SCOT-HEART randomised controlled trial of CCTA in patients with suspected stable angina. Mammograms were assessed visually for the presence and severity of BAC. RESULTS: BAC was identified in 93 (23%) patients. Patients with BAC were slightly older (63±7 versus 59±8 years, p<0.001), with a higher cardiovascular risk score (19±11 versus 16±10, p=0.022) and were more likely to be non-smokers (73% versus 49%, p<0.001). In patients with BAC, coronary artery calcification was present in 58 patients (62%; relative risk [RR] 1.26, 95% confidence intervals [CI]: 1.04, 1.53; p=0.02), non-obstructive coronary artery disease in 58 (62%; RR 1.27, 95% CI: 1.04 to 1.54, p=0.02), and obstructive coronary artery disease in 19 (20%; RR 1.62, 95% CI: 0.98, 2.66; p=0.058). Patients without BAC were very unlikely to have severe coronary artery calcification (negative predictive value 95%) but the diagnostic accuracy of BAC to identify coronary artery disease was poor (AUC 0.547). CONCLUSION: Although BAC is associated with the presence and severity of coronary artery calcification, the diagnostic accuracy to identify patients with coronary artery disease or obstructive coronary artery disease is poor.
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spelling pubmed-65129492019-06-01 Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study McLenachan, S. Camilleri, F. Smith, M. Newby, D.E. Williams, M.C. Clin Radiol Article AIM: To assess the prevalence of breast arterial calcification (BAC) in patients who also underwent routine surveillance mammography, and to determine the association with cardiovascular risk factors, coronary artery calcification, and coronary artery disease on coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Four hundred and five female participants were identified who had undergone CCTA and subsequent mammography in the SCOT-HEART randomised controlled trial of CCTA in patients with suspected stable angina. Mammograms were assessed visually for the presence and severity of BAC. RESULTS: BAC was identified in 93 (23%) patients. Patients with BAC were slightly older (63±7 versus 59±8 years, p<0.001), with a higher cardiovascular risk score (19±11 versus 16±10, p=0.022) and were more likely to be non-smokers (73% versus 49%, p<0.001). In patients with BAC, coronary artery calcification was present in 58 patients (62%; relative risk [RR] 1.26, 95% confidence intervals [CI]: 1.04, 1.53; p=0.02), non-obstructive coronary artery disease in 58 (62%; RR 1.27, 95% CI: 1.04 to 1.54, p=0.02), and obstructive coronary artery disease in 19 (20%; RR 1.62, 95% CI: 0.98, 2.66; p=0.058). Patients without BAC were very unlikely to have severe coronary artery calcification (negative predictive value 95%) but the diagnostic accuracy of BAC to identify coronary artery disease was poor (AUC 0.547). CONCLUSION: Although BAC is associated with the presence and severity of coronary artery calcification, the diagnostic accuracy to identify patients with coronary artery disease or obstructive coronary artery disease is poor. Blackwell Scientific Publications Ltd 2019-06 /pmc/articles/PMC6512949/ /pubmed/30803814 http://dx.doi.org/10.1016/j.crad.2019.01.014 Text en © 2019 The Royal College of Radiologists. Elsevier Ltd. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
McLenachan, S.
Camilleri, F.
Smith, M.
Newby, D.E.
Williams, M.C.
Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title_full Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title_fullStr Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title_full_unstemmed Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title_short Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study
title_sort breast arterial calcification on mammography and risk of coronary artery disease: a scot-heart sub-study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512949/
https://www.ncbi.nlm.nih.gov/pubmed/30803814
http://dx.doi.org/10.1016/j.crad.2019.01.014
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