Background The problem of common pathogenetic mechanisms of osteoporosis and atherosclerosis is relevant in today’s rheumatology and cardiology. It is shown that osteoporosis, atherosclerotic vascular defeat, calcification of the aorta and heart valves are interrelated pathological processes. The studies included mostly women, for men data are scarce and contradictory.
Objectives To examine the relationship between coronary atherosclerosis, coronary artery calcification, and indicators of bone mineral density (BMD) among males with coronary heart disease (CHD).
Methods 74 males with verified CHD were examined. BMD was assessed by dual energy absorptiometry (densitometer Exsell XR-46, Norland, the USA) with the definition of T-criterion of the proximal femur and lumbar spine (LI-LIV). Radiopaque selective coronarography was carried out using the ray unit «Innova», USA. Artery narrowing was considered hemodynamically significant that was more than 50% of its diameter. Analysis of the coronary artery lesions’ severity was carried out using the SYNTAX scale, quantification of coronary artery calcinosis was carried out using multislice computed tomography (MSCT). For quantitative traits the results are presented as median (Me) with an interquartile interval (25%, 75% percentiles). Depending on the values of the T-criterion, patients were divided into 3 groups: I - with osteoporosis (23 patients), aged 60 (57, 64) ; II - with osteopenia (30 patients), aged 58 (52, 65); III - with normal BMD (21 patients), aged 58 (54.5, 65.5.)
Results Three-vessel lesion was found in 43.5% in the group I, 46,7% in the group II, and 19.1% of patients in the group III. Single-vessel lesion among the patients with osteoporosis reported in 8.7% of cases, whereas in the group with normal BMD in 42.9% of cases, p = 0.049. Stenosis of three coronary arteries, including the defeat of the left main coronary artery identified in the group I, 73.9% of patients, whereas in group III in 35% of patients, p = 0.029. Significant differences in types of coronary disease among a group of osteopenia and other groups of patients were not identified. Severe coronary lesion by SYNTAX scale was recorded in 40% of patients in the osteopenia group and 9.52% in the group with normal BMD, p = 0.042. For moderate and very severe coronary lesion SYNTAX showed no statistically significant differences. The total value of the calcium index was 419.7 (25, 1106), 525 (185, 827) and 152.8 (0, 490), respectively, in I, II, and III groups, with significant differences between groups II and III (p = 0.012). Indicators of calcium index correlated significantly with the severity of coronary lesions on the SYNTAX scale (r = 0,53; p = 0,002). A negative weak force correlation was recognized between the index of T-criterion of the femoral neck and the number of affected arteries (r = -0,29; p = 0,014).
Conclusions Severe coronary lesions among males is correlated with coronary calcification and associated with decreased bone mineral density, which indicates the total units in the pathogenesis of atherosclerosis and osteoporosis.
Disclosure of Interest None Declared