DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20202559

A study on patients with coronary artery disease with special reference to bone mineral density

Tony Ete, Shakeel Ahamad Khan, Baphira Wankhar, Star Pala, Amit Malviya, Habung Mobing, Narang Naku, Amethyst Bamon, Utpal Kumar, Arun Kumar, Vanlalmalsawmdawngliana Fanai, Stephenson Pohlong, Animesh Mishra

Abstract


Background: Osteoporosis and Coronary artery disease are known to share common risk factors, like inflammation, but a direct relationship between the two has not been established. Some of the previous studies showed low BMD (osteoporosis and/orosteopenia) as an independent predictive factor for coronary artery disease in ambulatory patients. However, some reports have failed to demonstrate a direct relationship between low bone mineral density (BMD) and CAD or cardiovascular risk factors. This study was carried out to estimate bone mineral density (BMD) in patients with coronary artery disease (CAD) and also to evaluate the association between bone mineral density and coronary artery disease.

Methods: Hospital based prospective observational study, involving 96 consecutive patients who were referred for coronary angiography for the evaluation of established or suspected CAD and also patients who had acute coronary syndrome (ACS) are enrolled in this study. BMD was determined for the lumbar spine (L2-L4) and femoral neck using DXA scan.

Results: The total number of subjects was 96. Out of 96, 24 (25%) patients were females and remaining 72 (75%) were males. Coronary angiography was carried out in all patients. 42 patients from the total had coronary angiography proven single vessel disease (SVD), 33 patients had double vessel disease (DVD) and 21 patients had triple vessel disease (TVD). DXA scan was carried out in all patients. T- score of neck of femur region and lumbar spine was calculated. Neither the presence of significant coronary stenoses ≥50% in two or more coronary vessels nor the prevalence of severe coronary stenoses ≥70% differed significantly between patients with normal bone density, osteopenia, or osteoporosis (p<0.05, respectively).

Conclusions: The result of this study suggests that in patients undergoing coronary angiography for the evaluation of CAD, the prevalence of low BMD is high; however, there is no statistically significant relationship between osteoporosis, osteopenia and coronary artery disease state.


Keywords


Coronary artery disease, DXA scan, Osteoporosis, Osteopenia

Full Text:

PDF

References


Caidahl K, Ueland T, Aukrust P. Osteoprotegerin: a biomarker with many faces. Arterioscl Thromb Vascular Biol. 2010; 30(9):1684-6.

Marcovitz PA, Tran HH, Franklin BA, O’Neill WW, Yerkey M, Boura J, et al. Usefulness of bone mineral density to predict significant coronary artery disease. Am J Cardiol. 2005 Oct 15;96(8):1059-63.

Tekin GO, Kekilli E, Yagmur J, Uckan A, Yagmur C, Aksoy Y, et al. Evaluation of cardiovascular risk factors and bone mineral density in post menopausal women undergoing coronary angiography. Int J Cardiol. 2008 Dec 17;131(1):66-9.

Erbilen E, Yazici S, Özhan H, Bulur S, Ordu S, Yazici M. Relationship between angiographically documented coronary artery disease and low bone mass in men. Circulation J. 2007;71(7):1095-8.

WHO Scientific Group on the Prevention and Management of Osteoporosis (2000: Geneva, Switzerland) (2003). "Prevention and management of osteoporosis : report of a WHO scientific group" (PDF). Retrieved 2007-05-31.

WHO. "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group". World Health Organization technical report series. 1994;843:1-129.

WHO Scientific Group on the Prevention and Management of Osteoporosis (2000: Geneva, Switzerland) (2003). "Prevention and management of osteoporosis: report of a WHO scientific group”. Retrieved 2007.

Chen SJ, Lin CS, Lin CL, Kao CH. Osteoporosis Is Associated With High Risk for Coronary Heart Disease: A Population-Based Cohort Study. Medicine (Baltimore). 2015;94(27):e1146.

Lin T, Liu JC, Chang LY, Shen CW. Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women. Osteoporos Int. 2011 Feb;22(2):627-34.

Beer S, Saely CH, Hoefle G, Rein P, Vonbank A, Breuss J, et al. Low bone mineral density is not associated with angiographically determined coronary atherosclerosis in men. Osteoporos Int. 2010 Oct;21(10):1695-701.

Glüer CC, Eastell R, Reid DM, Felsenberg D, Roux C, Barkmann R, et al. Association of five quantitative ultrasound devices and bone densitometry with osteoporotic vertebral fractures in a population‐based sample: the OPUS Study. J Bone Mineral Res. 2004 May;19(5):782-93.

Saely CH, Koch L, Schmid F, Marte T, Aczel S, Langer P, et al. Lipoprotein (a), type 2 diabetes and vascular risk in coronary patients. European J Clinical Investigation. 2006 Feb;36(2):91-7.

Alissa EM, Alnahdi WA, Alama N, Ferns GA. Bone mineral density and cardiovascular risk factors in postmenopausal women with coronary artery disease. Bonekey Rep. 2015 Nov 11;4:758.

Häussler B, Gothe H, Göl D, Glaeske G, Pientka L, Felsenberg D. Epidemiology, treatment and costs of osteoporosis in Germany—the BoneEVA Study. Osteoporosis Int. 2007 Jan 1;18(1):77-84.

Ebeling PR. Clinical practice. Osteoporosis in men. N Engl J Med. 2008;358:1474-82.