PHARMACOLOGICAL TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE

Objective: Chronic heart failure (CHF) is a chronic multisystem disorder associated with a myriad of metabolic disturbances. Moreover, CHF may adversely affect bone metabolism and induce a severe bone loss, increasing susceptibility to fractures and osteoporosis. This study investigates the effect of combined calcium with Vitamin D3 supplement called “calcemin advance” and calcitonin in the prophylaxis and treatment of osteopenia and osteoporosis in patients with coronary heart disease (CHD) complicated by CHF with the establishment of their influence on the bone mineral density (BMD).Methods: A total of 59 patients with CHD complicated by CHF. Interventions: The physical examination findings, dual-energy X-ray absorptiometry findings, and treatment results were assessed.Results: The results of the calcemin advance usage in patients with osteopenic changes showed a positive dynamics of the studied parameters, both in the lumbar spine and in the femoral bone. In patients with osteoporosis, the usage of osteoprotective therapy (calcemin advance+miacalcic) contributed to the increasing of BMD in the lumbar spine and in the femoral bone versus patients who received only combined calcium with Vitamin D3 supplement.Conclusions: Our results suggest that bone density screening could be recommended in patients with prevalent CHF. Moreover, the results of our investigation substantiate the necessity and effectiveness of osteoprotective therapy in patients with CHF with osteoporosis by calcitonin (Miacalcic), in combination with combined calcium and Vitamin D3 supplement (calcemin advance), and by only calcemin advance - in patients with CHF and osteopenia.

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Investigation of calcium metabolism in patients with coronary heart disease complicated by chronic heart failure, stage ii-a

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v17i3.36994 ◽

2018 ◽

Vol 17 (3) ◽

pp. 395-401

Author(s):

Pohoretska Khrystyna ◽

Patskan Liudmyla ◽

Stoikevych Halyna ◽

Andriy Miz ◽

Marushchak Mariya ◽

...

Keyword(s):

Heart Failure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Chronic Heart Failure ◽

Calcium Metabolism ◽

Stage Ii ◽

Ionized Calcium ◽

Mineral Density ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Objective: This study aims to to investigate calcium metabolism indices and bone mineralization in patients with coronary heart disease complicated by stage II-A chronic heart failure.Materials and Methods: The study involved 33 men with coronary heart disease (CHD) complicated by Stage II-A chronic heart failure (according to the classification by N.D. Strazhesko, V.H. Vasilenko and G.F. Lung (1935). Bone mineral density was measured using dual energy x-ray densitometry of lumbar region of spine. The level of 25-hydroxyvitamin D (25(ОН)D) has been detected by ELISA method using commercial Vitamin D3 screening kit (Switzerland). The level of ionized calcium was measuring by ion selective method using analyser of electrolytes AEK-01 (QuertiMed, Ukraine).Results and Discussion: Structural and functional changes of bone tissue of the lumbar spine have been found in 49,2 percent patients with coronary heart disease complicated by Stage II-A chronic heart failure, in particular, I stage of osteopenia – in 44,6 %, II stage of osteopenia – in 27,7 %, III stage of osteopenia – in 10,8 % and osteoporosis – in 16,9 %. It was established the same type of downward trend for BMD decreasing in L1 of patients with different stages of osteopenia, but in case of osteoporosis mineralization decreased equally in all vertebrae. The analysis of calcium metabolism indices indicate that concentration of ionized calcium significantly decreased in patients with CHD complicated by Stage II-A chronic heart failure vs control (1.26±0.02 mmol/l) by 11.1 % (I stage of osteopenia), 18.3 % (II stage of osteopenia) and 31.7 % (III stage of osteopenia). Similar tendency was observed towards concentration of 25(ОН)D.Conclusion: In patients with CHD complicated by Stage II-A chronic heart failure we have established statistically significant decrease in serum level of ionized calcium and 25-hydroxyvitamin D concentration. However, we didn’t find the relationship between serum calcium, 25-hydroxyvitamin D concentration and bone mineral density. Structural and functional changes of bone tissue of the lumbar spine have been found in 49,2 percent patients with coronary heart disease complicated by Stage II-A chronic heart failure. It was established the same type of downward trend for BMD decreasing in L1 of patients with different stages of osteopenia, but in case of osteoporosis mineralization decreased equally in all vertebrae.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.395-401

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AB0910 SARCOPENIA AND BONE MINERAL DENSITY IN MEN WITH CORONARY HEART DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5401 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1757.2-1757

Author(s):

T. Raskina ◽

I. Grigoreva ◽

J. Averkieva ◽

A. Kokov ◽

V. Masenko

Keyword(s):

Bone Mineral Density ◽

Coronary Heart Disease ◽

Heart Disease ◽

Lumbar Spine ◽

Femoral Neck ◽

Muscle Mass ◽

Bone Mineral ◽

Mineral Density ◽

Group 3 ◽

Group 2

Objectives:To examine bone mineral density (BMD) in men with coronary heart disease (CHD), depending on the state of the muscle mass, strength and function.Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD and T-criterion (standart deviation, SD) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the Lunar Prodigy Primo bone densitometer (USA). The following reference intervals were used: normal BMD values (T-criterion ≥-1), osteopenia (OPe) (T-criterion from -1 to -2.5), and osteoporosis (OP) (T-criterion <-2.5).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “ skeletalmuscular index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2.Results:The femoral neck BMD in the examined patients was 0.96 (0.89; 1.03) g/cm2, which corresponds to -0.50 (-1.00; 0) SD according to the T-criterion, in the lumbar spine -1.23 (1.11; 1.32) g/cm2and 0.4 (-0.50; 1.20) SD according to the T-criterion.In accordance with the recommendations of the European working group on sarcopenia in Older people (EWGSOP, 2010, 2018), the patients were divided into 3 groups: 31 patients without sarcopenia (group 1), 21 patients with isolated muscle loss (presarcopenia) (group 2) and 27 patients with sarcopenia (group 3).BMD in the femoral neck in the group of patients without sarcopenia was 0.96 (0.72; 1.26) g/cm2, which corresponds to -0.50 (-0.8; 0.2) SD according to the T-criterion, in the lumbar spine – 1.19 (1.10; 1.275) g/cm2and 0.1 (-0.6; 0.8) SD according to the T-criterion. BMD in the femoral neck in the group of patients with presarcopenia (group 2) – 0.995 (0.94; 1.04) g/cm2and -0.3 (-0.70; 0) SD according to the T-criterion, in the lumbar spine – 1.32 (1.24; 1.40) g/cm2and 1.20 (0.50; 1.90) SD according to the T-criterion. In patients with established sarcopenia (group 3), the following indicators of BMD and T-criterion were recorded: 0.95 (0.845; 0.98) g/cm2and -0.60 (-1.40; -0.40) SD and 1.23 (0.085; 1.31) g/cm2and 0.4 (-0.8; 1.1) SD in the femoral neck and lumbar spine, respectively.A comparative analysis of the results of the DXA found that patients with sarcopenia had a significant decrease in the BMD and T-criterion in the femoral neck compared to patients with presarcopenia (p=0.039 and p=0.040, respectively). There were no differences between the groups of patients without sarcopenia and with sarcopenia and presarcopenia (p>0.05).It was found that patients with sarcopenia had significantly lower BMD and T-criterion in the lumbar spine compared to patients with presarcopenia (p=0.017 and p=0.0165, respectively). The values of the BMD and T-criterion in the groups of patients without sarcopenia and with presarcopenia and sarcopenia in the lumbar spine were comparable (p>0.05).Conclusion:The presence of sarcopenia is associated with loss of BMD in the femoral neck and in the lumbar spine. The results obtained confirm the high probability of common pathogenetic links between OP and sarcopenia.Disclosure of Interests:None declared

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