Mammography as Screening for Coronary Artery Disease

Coronary artery disease (CAD) is the leading cause of death in American women. Screening mammograms are recommended for women starting at age 40 for the early detection of breast cancer. An additional benefit of this routine screening tool may be to detect breast arterial calcifications (BAC) as a possible sign of CAD. The purpose of this study was to determine further the relationship between mammographically detected BAC and CAD. The medical records of 44 women who had undergone coronary artery bypass grafting at our institution over 5 years were reviewed. These mammograms were examined for evidence of BAC. For all women included in the study, 18 of 44 (41%) had evidence of BAC on screening mammogram. This was statistically significant ( P < 0.0001) compared with the prevalence of BAC reported in the general population in previous studies. Most were also overweight (61.1%), had hypertension (88.8%), and hypercholesterolemia (55.5%). This is the first study to look at the direct correlation between patients with known CAD requiring revascularization and BAC. Perhaps women with BAC seen on screening mammography should undergo further workup for CAD, with the potential benefit of early intervention.

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Breast artery calcium noted on screening mammography is predictive of high risk coronary calcium in asymptomatic women: a case control study

VASA ◽

10.1024/0301-1526/a000312 ◽

2013 ◽

Vol 42 (6) ◽

pp. 429-433 ◽

Cited By ~ 19

Author(s):

Martin E. Matsumura ◽

Crystal Maksimik ◽

Matthew W. Martinez ◽

Michael Weiss ◽

James Newcomb ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

High Risk ◽

Coronary Artery Calcium ◽

Screening Mammography ◽

Artery Disease ◽

The Relationship ◽

Asymptomatic Women ◽

Cad Risk

Background: The relationship between breast artery calcification (BAC) noted on mammography and both coronary artery disease and cardiovascular risk remains controversial. Few studies have examined the clinical significance of BAC in asymptomatic women. In the present study we evaluated the relationship between BAC and coronary artery calcium (CAC) as identified by multi-slice CT scanning (MSCT). Patients and methods: Consecutive women (n = 98) with BAC noted on routine mammography but without known coronary artery disease (CAD) were assessed for CAD risk factors and had assessment of coronary calcium by MSCT. A control cohort of consecutive women who were BAC(-) (n = 104) underwent an identical assessment. Results: Women who were BAC(+) were older than those who were BAC(-); otherwise, there were no differences between the 2 groups with regard to traditional cardiac risk factors. Significantly more BAC(+) vs. BAC(-) women were found to have high risk CAC scores, defined as CAC > 400 (11.2 % vs. 1.0 %, p = 0.006). However, the rates of CAC scores of 0 were not different between the two groups (50.0 % vs. 54.8 % for BAC(+) and BAC(-) , respectively, p = 0.586). When examined in a multivariate model including the traditional risk factors of diabetes, increasing age, smoking, hyperlipidemia, and family history of CAD, the presence of BAC remained significantly associated with CAC > 400 (OR = 22.6, 95 % CI = 2.1 - 237.1). Conclusions: The presence of breast artery calcium on screening mammography was a strong independent predictor (odds ratio > 22) of high risk coronary artery calcium scores (defined as CAC > 400). The presence of BAC in those with significant CAD risk factors may warrant further evaluation.

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Comparing Risk-adjusted Hospital Mortality for CABG and AMI Patients

Journal of International Medical Research ◽

10.1177/147323000503300408 ◽

2005 ◽

Vol 33 (4) ◽

pp. 425-433 ◽

Cited By ~ 4

Author(s):

HK Park ◽

HS Ahn ◽

SJ Yoon ◽

HY Lee ◽

JM Hong ◽

...

Keyword(s):

Coronary Artery ◽

Mortality Rate ◽

Predictive Model ◽

Medical Records ◽

Artery Bypass ◽

Bypass Graft ◽

Acceptable Range ◽

Artery Disease ◽

Cabg Patients ◽

The Relationship

The objectives of this study were to compare the risk-adjusted mortality of coronary artery bypass graft (CABG) and acute myocardial infarction (AMI) patients simultaneously in six hospitals in Seoul, Korea, and to investigate the relationship between these performance measures by developing a predictive model of mortality. The medical records of 749 AMI and 564 CABG patients were reviewed. A predictive model was developed using logistic regression, including 170 variables selected as risk factors for risk adjustment. The validity of our predictive model was demonstrated to be within an acceptable range. The results showed that one hospital with a significantly low AMI mortality rate also had a low CABG mortality rate, while another hospital with a significantly high AMI mortality rate also had a high CABG mortality rate. Our results implied that hospitals providing good-quality medical management of coronary artery disease also provided a good-quality surgical service.

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Mammographically Detected Breast Arterial Calcification—A Marker of Coronary Artery Disease in Women

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0038-1622963 ◽

2017 ◽

Vol 02 (04) ◽

pp. 082-085

Author(s):

Padmasri Gorantla ◽

Anu Kapoor ◽

Jyotsna Maddury

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Predictive Value ◽

Screening Tool ◽

Coronary Calcification ◽

Population Based ◽

Screening Mammography ◽

Arterial Calcification ◽

Mortality And Morbidity ◽

Artery Disease

Abstract Background and Aim Coronary artery disease (CAD) resulting from atherosclerosis is one of the major causes of mortality and morbidity worldwide and is still a leading cause of death in women older than 40 years. The gold standard for diagnosis of CAD is by coronary angiography (CAG). However, this procedure is both invasive and expensive and thus is not suitable as a screening tool in asymptomatic individuals. Like coronary calcification, atherosclerotic vascular calcification involving small-to-medium–sized arteries is also observed in the breast. Modern mammographic equipment is very sensitive in the detection of microcalcifications. The aim of this study is to study the relationship between mammographically detected breast arterial calcification (BAC) and CAD and to evaluate the role of BAC as a marker for CAD. Methods Twenty female patients older than 40 years who had undergone CAG for suspected CAD were included in the study. Screening mammograms were performed and analyzed for the presence of BAC. The results were analyzed for correlation between severity of BAC and CAD. Results Twenty patients with mean age of 56.45 (age range: 40–68) were evaluated. BACs were found in 60% of these cases with a peak age group of 56 to 60 years. BAC was bilateral (92%) in most cases. CAG reports were positive for CAD in 45% of patients. The sensitivity of BAC in predicting CAD was 77.7% with a specificity of 54.5%, positive predictive value (PPV) of 58.3%, and negative predictive value (NPV) of 75%. Conclusion Screening mammography has a potential to serve as a noninvasive tool for early detection of CAD in asymptomatic women. Larger population-based studies with controls will be required to establish the utility of this screening tool.

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