Brendan S Kelly1, Emer ScanlON2, Helen Heneghan3, Ciaran E Redmond4, Gerard M Healy4, Enda Mc Dermott3, Eric J Heffernan4, Ruth Prichard3, Sorcha Mc Nally5. 1. Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland; Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: brendanskelly@me.com. 2. School of Medicine and Medical Science, UCD, Belfield D4, Ireland. 3. Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. 4. Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland. 5. Department of Radiology, St Vincent's University Hospital, Elm Park Dublin 4, Ireland; Breast Check, St Vincent's Healthcare Group, Elm Park Dublin 4, Ireland.
Abstract
INTRODUCTION: Breast Arterial Calcification (BAC) on digital mammography has been associated with an increased risk of Coronary Artery Disease (CAD). We aimed to investigate the association of BAC with findings on Coronary Computed Tomography Angiography (CCTA) within a cohort of women from the national breast screening program. METHODS: Symptomatic women (chest pain) aged between 50 and 65 who underwent a CCTA and who also had a screening mammography between 2014 and 2015 were recorded. BAC and CAD-RADS™: Coronary Artery Disease-Reporting and Data System were scored by separate blinded specialist radiologists. Cardiac risk factors were recorded. Patients' cardiac follow up (with Exercise Stress Test, Percutaneous Coronary Intervention or echocardiography) and cardio-protective medications were also documented. RESULTS: 219 eligible women underwent a CCTA. Of these, 104 patients also underwent digital mammography. Using standard linear regression BAC was identified as a significant predictor of CAD-RADs ≥3 disease. Using binomial logistic regression, BAC remained associated with CAD-RADs ≥3 (p=0.023). A significantly higher proportion of patients with BAC >1 were on cardio-protective medications (p=0.041) and had medications initiated or changed, or had further cardiac investigation (p=0.037 and p=0.019, respectively) than those with no BAC, after a mean follow-up of 20.6 (range 15-27) months. CONCLUSION: BAC diagnosed on 2 yearly screening mammography predicts CAD-RADs ≥3 disease in symptomatic patients.
INTRODUCTION: Breast Arterial Calcification (BAC) on digital mammography has been associated with an increased risk of Coronary Artery Disease (CAD). We aimed to investigate the association of BAC with findings on Coronary Computed Tomography Angiography (CCTA) within a cohort of women from the national breast screening program. METHODS: Symptomatic women (chest pain) aged between 50 and 65 who underwent a CCTA and who also had a screening mammography between 2014 and 2015 were recorded. BAC and CAD-RADS™: Coronary Artery Disease-Reporting and Data System were scored by separate blinded specialist radiologists. Cardiac risk factors were recorded. Patients' cardiac follow up (with Exercise Stress Test, Percutaneous Coronary Intervention or echocardiography) and cardio-protective medications were also documented. RESULTS: 219 eligible women underwent a CCTA. Of these, 104 patients also underwent digital mammography. Using standard linear regression BAC was identified as a significant predictor of CAD-RADs ≥3 disease. Using binomial logistic regression, BAC remained associated with CAD-RADs ≥3 (p=0.023). A significantly higher proportion of patients with BAC >1 were on cardio-protective medications (p=0.041) and had medications initiated or changed, or had further cardiac investigation (p=0.037 and p=0.019, respectively) than those with no BAC, after a mean follow-up of 20.6 (range 15-27) months. CONCLUSION: BAC diagnosed on 2 yearly screening mammography predicts CAD-RADs ≥3 disease in symptomatic patients.
Authors: Sing Ching Lee; Michael Phillips; Jamie Bellinge; Jennifer Stone; Elizabeth Wylie; Carl Schultz Journal: PLoS One Date: 2020-07-28 Impact factor: 3.240