Association between vertebral bone mineral density, myocardial perfusion, and long-term cardiovascular outcomes: A sex-specific analysis.
Aged
Ammonia
Bone Density
Cardiovascular Diseases
/ diagnostic imaging
Disease-Free Survival
Female
Heart
/ diagnostic imaging
Humans
Male
Middle Aged
Myocardial Perfusion Imaging
/ methods
Nitrogen Radioisotopes
Positron Emission Tomography Computed Tomography
Retrospective Studies
Risk
Risk Factors
Sex Factors
Thoracic Vertebrae
/ diagnostic imaging
Treatment Outcome
CAD
MPI
PET
diagnostic and prognostic application
molecular imaging
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
01
04
2019
accepted:
22
04
2019
pubmed:
10
7
2019
medline:
31
8
2021
entrez:
10
7
2019
Statut:
ppublish
Résumé
Sexual dimorphism in the manifestation of coronary artery disease (CAD) has unleashed a call to reconsider cardiovascular risk assessment. Alterations of bone mineral density (BMD) have been associated with congestive heart failure and appear to be modified by sex. However, the sex-specific association between BMD, myocardial perfusion, and cardiovascular outcomes is currently unknown. A total number of 491 patients (65.9 ± 10.7 years, 32.4% women) underwent Event-free survival (median follow-up time of 4.3 ± 2.0 years) was significantly reduced in patients with low (≤ 100 Hounsfield units) compared to those with higher BMD (log-rank P = .037). Accordingly, reduced BMD was chosen as significant predictor of MACE in a fully adjusted proportional hazards regression model (P = .015). Further, a first-order interaction term consisting of sex and BMD was statistically significant (P = .007). BMD was significantly lower in patients with abnormal myocardial perfusion or impaired left ventricular ejection fraction (P < .05). This difference, however, was noticed in men, but not in women. The association between low BMD and cardiovascular disease is sex dependent. Our data suggest that quantification of BMD during myocardial perfusion imaging for evaluation of CAD may be particularly useful in men.
Sections du résumé
BACKGROUND
Sexual dimorphism in the manifestation of coronary artery disease (CAD) has unleashed a call to reconsider cardiovascular risk assessment. Alterations of bone mineral density (BMD) have been associated with congestive heart failure and appear to be modified by sex. However, the sex-specific association between BMD, myocardial perfusion, and cardiovascular outcomes is currently unknown.
METHODS
A total number of 491 patients (65.9 ± 10.7 years, 32.4% women) underwent
RESULTS
Event-free survival (median follow-up time of 4.3 ± 2.0 years) was significantly reduced in patients with low (≤ 100 Hounsfield units) compared to those with higher BMD (log-rank P = .037). Accordingly, reduced BMD was chosen as significant predictor of MACE in a fully adjusted proportional hazards regression model (P = .015). Further, a first-order interaction term consisting of sex and BMD was statistically significant (P = .007). BMD was significantly lower in patients with abnormal myocardial perfusion or impaired left ventricular ejection fraction (P < .05). This difference, however, was noticed in men, but not in women.
CONCLUSIONS
The association between low BMD and cardiovascular disease is sex dependent. Our data suggest that quantification of BMD during myocardial perfusion imaging for evaluation of CAD may be particularly useful in men.
Identifiants
pubmed: 31286420
doi: 10.1007/s12350-019-01802-z
pii: 10.1007/s12350-019-01802-z
doi:
Substances chimiques
Nitrogen Radioisotopes
0
Nitrogen-13
0
Ammonia
7664-41-7
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM