Oral Calcium Supplements Associate With Serial Coronary Calcification

Bazarbashi, Najdat; Kapadia, Samir; Nicholls, Stephen J.; Carlo, Julie; Gad, Mohamed M.; Kaur, Manpreet; Karrthik, Antonette; Sammour, Yasser; Diab, Mohamed; Ahuja, Keerat Rai; Tuzcu, E. Murat; Nissen, Steven E.; Puri, Rishi

doi:10.1016/j.jcmg.2020.06.030

Cited by 17 publications

(6 citation statements)

References 32 publications

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“…In a post hoc analysis of nine randomized trials investigating the effect of calcium supplementation on calcium indices (CaI) and atheroma volume (AV), calcium supplementation was associated with an increase in the annualized CaI (odds ratio, 1.15; P=0.004) and no change in AV. Although the authors adjusted for multiple confounders, one of the limitations of this study is that the participants were asked about their "medication use" rather than their "supplement" use [29]. Manson et al [30] investigated the effect of calcium supplementation (1,000 mg) and vitamin D (400 IU) on the coronary artery calcium (CAC) score in a substudy of the WHI trial.…”

Section: Skeletal and Extraskeletal Effects Of Calcium And Vitamin Dmentioning

confidence: 99%

Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review

et al. 2023

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Calcium and vitamin D play an important role in mineral homeostasis and the maintenance of skeletal health. Calcium and vitamin D supplements have been widely used for fracture prevention in elderly populations. Many trials have studied the effectiveness and cardiovascular safety of calcium and vitamin D supplementation, with disparate results. In this review, we summarize the most important trials and systematic reviews. There is significant heterogeneity in clinical trial design, differences in the nature of trial outcomes (self-reported vs. verified), prior calcium intake, and trial size. Inconsistent results have been reported concerning the effects of calcium and vitamin D supplementation on cardiovascular outcomes. Most current guidelines recommend calcium intake of up to 1,200 mg daily, preferably from the diet, without concern for cardiovascular risk. Recommendations regarding vitamin D supplementation vary widely. There is compelling evidence from well-conducted randomized trials that modest vitamin D supplementation is safe but does not confer cardiovascular benefit or cardiovascular harm.

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Section: Skeletal and Extraskeletal Effects Of Calcium And Vitamin Dmentioning

confidence: 99%

Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review

et al. 2023

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“…In contrast, calcium intake from calcium supplements was seemly associated with an increased risk of cardiovascular death 25 , 39 – 41 . An IVUS study by Najdat Bazarbashi et al found that oral calcium supplements may increase calcium deposition in coronary vessels, leading to poor prognosis 42 . The mechanism of oral calcium supplements increasing cardiovascular risk is unclear, likely associated with the sudden increase in serum calcium.…”

Section: Discussionmentioning

confidence: 99%

Association between serum calcium level and in-hospital mortality in patients with acute myocardial infarction: a retrospective cohort study

Fang

Chen

2022

Sci Rep

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The association between serum calcium levels and the prognosis of patients with acute myocardial infarction (AMI) remains controversial. This study aimed to explore the association between serum calcium and in-hospital mortality in patients with AMI. The data of this study were extracted from the Philips eICU Collaborative Research Database. A total of 7284 patients were eventually enrolled in this study, of which 799 (10.97%) died during hospitalization. For each patient, serum calcium, corrected to albumin, was calculated and categorized into four groups: Q1 ≤ 8.5, Q2 8.5–9.5, Q3 9.5–10.5, and Q4 > 10.5 mg/dL. Multivariate analysis demonstrated that corrected sCa was an independent predictor of in-hospital death (Q2 vs. Q1, OR 0.5, 95% CI 0.4–0.7, P < 0.001; Q3 vs. Q1, OR 0.8, 95% CI 0.6–1.0, P = 0.035; Q4 vs. Q1, OR 1.6, 95% CI 1.1–2.3, P = 0.008). The association remained stable in the fully adjusted model. A significant U-shaped association between corrected serum calcium and in-hospital mortality was observed in piecewise linear regression model (Corrected sCa < 9.4 mg/dL, OR 0.8, 95% CI 0.7–0.9, P < 0.001; corrected sCa > 9.4 mg/dL, OR 1.5, 95% CI 1.3–1.8, P < 0.001). In conclusion, both decreased and increased corrected serum calcium is associated with increased in-hospital mortality in patients with AMI, and patients may have the lowest risk of in-hospital death when corrected serum calcium is 9.4 mg/dL (2.35 mmol/L).

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“…37 An intravascular ultrasound study also found that oral calcium supplementation may increase calcium deposition in the coronary vasculature independent of changes in atheroma volume. 38 However, the Women’s Health Initiative Calcium/vitamin D Supplementation Study (WHI CaD) reported that calcium carbonate and vitamin D supplementation had no adverse effect on any cardiovascular endpoints or on coronary artery calcification. 39 Also, the Framingham study does not support the hypothesis that high calcium intake increases coronary artery calcification.…”

Section: Discussionmentioning

confidence: 99%

Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis

Zhang

Liu

et al. 2022

Therapeutic Advances in Chronic Disease

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Background: The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC. Methods: We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed. Results: Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI: 1.11 - 4.02, P = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI: 23.77 - 43.77, p = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI: 0.92 - 1.10, p = 0.95, age-adjusted), and 0.95 (95% CI: 0.86 - 1.05, p = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity. Conclusions: Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.

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Oral Calcium Supplements Associate With Serial Coronary Calcification

Cited by 17 publications

References 32 publications

Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review

Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review

Association between serum calcium level and in-hospital mortality in patients with acute myocardial infarction: a retrospective cohort study

Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis

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