Loïc Panh1, Jean Bernard Ruidavets2, Hervé Rousseau3, Antoine Petermann3, Vanina Bongard2, Emilie Bérard2, Dorota Taraszkiewicz1, Olivier Lairez1, Michel Galinier1, Didier Carrié1, Jean Ferrières4. 1. Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France. 2. Department of Epidemiology, Unité de Soutien Méthodologique à la Recherche (USMR), Toulouse University Hospital (CHU), 37 Allées Jules Guesde, 31073 Toulouse Cedex 7, France. 3. Department of Radiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France. 4. Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France. Electronic address: jean.ferrieres@univ-tlse3.fr.
Abstract
BACKGROUND AND AIMS: A high level of serum alkaline phosphatase (ALP) is associated with an increased risk of mortality and myocardial infarction. ALP hydrolyses inorganic pyrophosphate, which is a strong inhibitor of calcium phosphate deposition. The aim of this study was to determine whether ALP is associated with the coronary artery calcium score (CACS). METHODS: We examined the association of CACS, assessed by computed tomography scanning, and ALP, in 500 patients consecutively recruited, free of cardiovascular disease. The CACS were categorized into two groups: no calcification (CACS = 0) (n = 187) and with calcification (CACS>0) (n = 313). ALP activity was divided into three tertile groups: low ALP level (<55 IU/L), intermediate (55-66 IU/L) and high ALP level (>66 IU/L). RESULTS: The mean age was 60.9 ± 10.8 years, 49.6% of the patients were women. ALP ranged from 22 to 164 IU/L (mean 62.6 IU/L, SD 19.3). In univariate analysis, traditional cardiovascular risk factors, statin use (p = 0.001), and ALP (p = 0.001) were significantly associated with CACS. After adjusting for cardiovascular risk factors, only age (p = 0.001) and sex (p = 0.001) were independently associated with CACS. Compared to the tertile group with low levels of ALP, the intermediate tertile group [OR 2.11, 95% CI (1.12; 3.96), p = 0.02], as well as the high tertile group [OR 3.89, 95% CI (2.01; 7.54), p = 0.001)], was independently associated with CACS. CONCLUSIONS: In patients free of cardiovascular disease, high ALP levels are positively and independently associated with coronary artery calcification. The metabolic pathway of ALP and inorganic pyrophosphate could be a target for new therapies against vascular calcification.
BACKGROUND AND AIMS: A high level of serum alkaline phosphatase (ALP) is associated with an increased risk of mortality and myocardial infarction. ALP hydrolyses inorganic pyrophosphate, which is a strong inhibitor of calcium phosphate deposition. The aim of this study was to determine whether ALP is associated with the coronary artery calcium score (CACS). METHODS: We examined the association of CACS, assessed by computed tomography scanning, and ALP, in 500 patients consecutively recruited, free of cardiovascular disease. The CACS were categorized into two groups: no calcification (CACS = 0) (n = 187) and with calcification (CACS>0) (n = 313). ALP activity was divided into three tertile groups: low ALP level (<55 IU/L), intermediate (55-66 IU/L) and high ALP level (>66 IU/L). RESULTS: The mean age was 60.9 ± 10.8 years, 49.6% of the patients were women. ALP ranged from 22 to 164 IU/L (mean 62.6 IU/L, SD 19.3). In univariate analysis, traditional cardiovascular risk factors, statin use (p = 0.001), and ALP (p = 0.001) were significantly associated with CACS. After adjusting for cardiovascular risk factors, only age (p = 0.001) and sex (p = 0.001) were independently associated with CACS. Compared to the tertile group with low levels of ALP, the intermediate tertile group [OR 2.11, 95% CI (1.12; 3.96), p = 0.02], as well as the high tertile group [OR 3.89, 95% CI (2.01; 7.54), p = 0.001)], was independently associated with CACS. CONCLUSIONS: In patients free of cardiovascular disease, high ALP levels are positively and independently associated with coronary artery calcification. The metabolic pathway of ALP and inorganic pyrophosphate could be a target for new therapies against vascular calcification.
Authors: Filippo Romanelli; AnthonyMarco Corbo; Maryam Salehi; Manisha C Yadav; Soha Salman; David Petrosian; Omid J Rashidbaigi; Jesse Chait; Jes Kuruvilla; Maria Plummer; Ilian Radichev; Kenneth B Margulies; A Martin Gerdes; Anthony B Pinkerton; José Luis Millán; Alexei Y Savinov; Olga V Savinova Journal: PLoS One Date: 2017-10-12 Impact factor: 3.240