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Prognostic value of lower bone mineral density in predicting adverse cardiovascular disease in Asian women

Authors
 Jiesuck Park  ;  Yeonyee Elizabeth Yoon  ;  Kyoung Min Kim  ;  In-Chang Hwang  ;  Wonjae Lee  ;  Goo-Yeong Cho 
Citation
 HEART, Vol.107(13) : 1040-1046, 2021-07 
Journal Title
HEART
ISSN
 1355-6037 
Issue Date
2021-07
Keywords
coronary artery disease
Abstract
Objective: We investigated whether the evaluation of bone mineral density (BMD) provides independent and incremental prognostic value for predicting atherosclerotic cardiovascular disease (ASCVD) in women.

Methods: A total of 12 681 women aged 50-80 years (mean, 63.0±7.8 years) who underwent dual-energy X-ray absorptiometry were retrospectively analysed. We assessed the hazard ratio (HR) for ASCVD events (ASCVD death, non-fatal myocardial infarction and ischaemic stroke) according to the BMD or a clinical diagnosis of osteopenia or osteoporosis, with adjustment for clinical risk factors, including age, body mass index, hypertension, type 2 diabetes, hyperlipidaemia, current smoking and previous fracture. We also evaluated whether the addition of BMD or a clinical diagnosis of osteopenia or osteoporosis to clinical risk factors improved the prediction for ASCVD events.

Results: In total, 468 women (3.7%) experienced ASCVD events during follow-up (median, 9.2 years). Lower BMD at the lumbar spine, femur neck and total hip was independently associated with higher risk for ASCVD events (adjusted HR per 1-standard deviation decrease in BMD: 1.16, p<0.001; 1.29, p<0.001; 1.38, p<0.001; respectively). A clinical diagnosis of osteoporosis was also independently associated with higher risk for ASCVD events (adjusted HR: 1.79, p<0.001). The addition of BMD or a clinical diagnosis of osteopenia or osteoporosis to clinical risk factors demonstrated significant incremental value in discriminating ASCVD events (addition of total hip BMD, p for difference <0.001).

Conclusion: The evaluation of BMD provides independent and incremental prognostic value for ASCVD in women and thus may improve risk stratification in women.
Full Text
https://heart.bmj.com/content/107/13/1040.long
DOI
10.1136/heartjnl-2020-318764
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Min(김경민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184391
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