FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score

Chuang, Tzyy‐Ling; Li, Yida; Hsiao, Fu-Tsung; Chuang, Mei-Hua; Wang, Yuh-Feng

doi:10.1155/2017/1592598

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…In line with an earlier review [9], we found significant independent associations between BA, prevalent VFs, and high Agatston score. An association between VFs and Agatston score is consistent with the reported correlation of FRAX-estimated risk of hip fracture or major osteoporotic fracture with CAC score [38]. Some linking mechanisms have been proposed, such as an association between micro-and macro-vessel damage and altered microarchitectural indices in the radius [39], or between decreased vascular flow in the lower extremities and increased rate of bone loss at the hip and calcaneus in older women [40].…”

Section: Discussionsupporting

confidence: 80%

Association between vertebral fractures and coronary artery calcification in current and former smokers in the ECLIPSE cohort

et al. 2019

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In smokers and former smokers from the ECLIPSE cohort, there is an association between prevalent vertebral fractures (VFs) and coronary artery calcification (CAC). Chest CT scans provide the opportunity to evaluate VFs and CAC, which are potentially important comorbidities, each of which is amenable to effective interventions. Introduction Prevalence of VFs among smokers and patients with chronic obstructive pulmonary disease (COPD) is high, and an association between CAC and osteoporosis has been described. We investigated the associations between VFs and CAC (expressed in Agatston score) in (former) smokers. Methods Current and former smokers from the ECLIPSE study (designed to determine underlying COPD progression mechanisms) were studied. Baseline Agatston score (zero (0), medium (1-400), or high (> 400)), baseline bone attenuation (BA), and prevalent and incident VFs (vertebrae T 1-L 1) were assessed on CT. Results A total of 586 subjects were included (mean age 59.8 ± 8.3; 62.3% men; 70.1% with COPD; 21.0% with prevalent VFs; 196 with zero, 266 with medium, and 124 with high Agatston score). Of these, 23.4% suffered incident VFs within 3 years. In multivariate models, prevalent VFs were associated with medium (1.83 [95% CI 1.01-3.30]) and with high (OR = 3.06 [1.45-6.47]) Agatston score. After adjustment for BA, prevalent VFs were still associated with high (OR = 2.47 [1.13-5.40]), but not significantly with medium Agatston score (OR = 1.57 [0.85-2.88]). Similarly, after adjustment for BA, high (OR = 2.06 [1.02-4.13]) but not medium Agatston score (OR = 1.61 [0.88-2.94]) was associated with prevalent VFs. Agatston score at baseline was not associated with short-term VF incidence.

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Section: Discussionsupporting

confidence: 80%

Association between vertebral fractures and coronary artery calcification in current and former smokers in the ECLIPSE cohort

et al. 2019

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“…In the study, their correlation between BMD and CAC score was more significant for the femur area than for the lumbar spine. In another study analyzing FRAX ® and CAC, only the right femoral neck T-score and left total hip T-score showed a significantly inverse relationship with the CAC score [ 34 ].…”

Section: B One Mineral Density and Cardiovascular Disease/cmentioning

confidence: 99%

“…Fracture risk, rather than mere BMD, was significantly positively correlated with CAC scores. This correlation is probably because, in addition to the BMD value, the calculation of major osteoporotic fracture and hip fracture risk takes into account other fracture risk factors [ 34 ].…”

Section: Frax ® and Cardiovascular Disease/coronmentioning

confidence: 99%

“…If fragility fractures of the bone and VC have reciprocal causation and are mutually related, their involved, dynamic, highly regulated processes in the physiologic microenvironment of the bone and vessels may provide a more reasonable explanation for this linkage. FRAX ® can help identify individuals at high risk of osteoporotic fractures, an increased CAC score, and cardiovascular events [ 34 ]. The relationship between fractures and CVD may be explained by the mechanisms that explain low BMD [ 40 ].…”

Section: Echanismmentioning

confidence: 99%

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Association of bone mineral density and trabecular bone score with cardiovascular disease

Chuang

Koo

et al. 2020

Tzu Chi Med J

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Traditionally, osteoporosis and cardiovascular disease (CVD) are considered as separate chronic diseases. Increasing evidence now links osteoporosis with hypertension, abnormal lipid metabolism, atherosclerosis, vascular calcification (VC), and congestive heart failure. VC coexists with bone loss, and aortic calcification is a strong predictor of low bone mineral density (BMD) and fragility fractures. The same holds true for coronary artery calcification (CAC): the lower the BMD, the higher the CAC. Trabecular bone score (TBS) iNsight software can analyze the existing BMD database to obtain the bony microstructure score (TBS). Many TBS-related studies include fracture risk, normal aging, diabetes, potential genes, obesity, and asthma severity prediction. The inverse relationship of TBS to VC may provide insight into bone–vascular interactions in chronic kidney disease. A higher TBS has been associated with moderate, but not high, CAC. One explanation is that bone microstructural remodeling becomes more active during early coronary calcification. Increased risk of 10-year likelihood of hip fracture and major osteoporotic fracture as estimated by the fracture risk assessment tool FRAX ® is significantly and independently associated with more severe CAC scores. Dual-energy X-ray absorptiometry and FRAX ® can be used to predict fracture risk and CAC scores, identifying patients who may benefit from early intervention. This review will discuss the relationship and possible mechanism of BMD, TBS, and FRAX ® with CVD and VC or CAC.

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“…Arterial calcification is one of the independent predictor factors of vascular morbidity and mortality in the elderly population [ 5 ]. It has been reported that if there is a significant association between fragility fractures and vascular calcification, it can be explained by the fact that these vessels and bones are a dynamic process related to the physiological microenvironment [ 6 ]. Local and systemic osteogenic factors that may be released from calcified atherosclerotic lesions may affect bone homeostasis [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Does Presence of Femoral Arterial Calcification Have an Effect on Postoperative Complication and Mortality in Patients With Hip Fracture?

Birişik¹,

Bilgin²,

Bayram³

et al. 2021

Cureus

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Introduction In this study, we investigated the relationship between femoral arterial calcification on preoperative hip radiography and post-operative complications and all-time mortality rates in patients with hip fracture >65 years old. Methods This retrospective study was conducted by evaluating the records of patients who were operated for hip fractures. All patients were divided into two groups according to the presence of lower extremity arterial calcification (LEAC) at the femoral artery which was diagnosed using the hip radiograph. The patients with and without the presence of LEAC were assigned as groups 1 and 2, respectively. A multivariate Cox algorithm was applied to recognize whether this radiological factor is independently associated with survival. Results The study included 530 patients (540 hips; 191 males and 339 females) with an average age of 80.8 ± 7.6 years. In the study after 24.8±19.9 months (range:0-65 months) follow-up period, 336 (63.3%) patients had expired. Conversely, 194 (36.7%) patients are surviving. Survival rates at one month and one year after surgery were 89.5% and 65.7%, respectively. 234 of 540 hips (230 patients) have LEAC on the femoral artery. The survival rate at one month, one year, and overall survival were significantly higher in patients with LEAC. The postoperative infection rate was also two times higher in patients with LEAC than without LEAC (p = 0.021). Multivariate analysis demonstrated that age, treatment modality (hemiarthroplasty), and the presence of femoral arterial calcification were independently associated with poor overall survival. Conclusions In our study, we found that the presence of femoral arterial calcification on the affected side of the hip identified on hip radiograph was independently associated with poor one month, one year, and overall survival as the patients had 1.5 times higher mortality rate. Additionally, a significant correlation was found between age and survival of patients with hip fracture, especially patients >80 years old.

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FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score

Cited by 9 publications

References 21 publications

Association between vertebral fractures and coronary artery calcification in current and former smokers in the ECLIPSE cohort

Association between vertebral fractures and coronary artery calcification in current and former smokers in the ECLIPSE cohort

Association of bone mineral density and trabecular bone score with cardiovascular disease

Does Presence of Femoral Arterial Calcification Have an Effect on Postoperative Complication and Mortality in Patients With Hip Fracture?

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