ASSOCIATION OF MINERAL BONE DENSITY AND RISK OF OSTEOPOROTIC FRACTURES WITH CORONARY AND CAROTID ATHEROSCLEROSIS IN MALE PATIENTS WITH STABLE ANGINA

Aim. To assess the severity of coronary and carotid atherosclerosis in male patients with stable angina depending on their bone mineral density and the risk of osteoporotic fractures. Materials and Methods. We recruited 102 consecutive male patients (> 50 years of age) with stable angina awaiting coronary artery bypass graft surgery (median age 61 years). All study participants underwent coronary angiography, multislice computed tomography angiography, carotid artery duplex scan, and dual-energy X-ray absorptiometry. To define the severity of coronary atherosclerosis, we applied SYNTAX score while coronary artery calcification was evaluated utilizing the Agatston score. The extent of carotid atherosclerosis was assessed by intima-media thickness and percent diameter stenosis. Results. Almost half of the patients (46.1%) were diagnosed with multivessel coronary artery disease. High SYNTAX score (≥ 33) and severe coronary artery calcification (Agatston score > 400) were revealed in 17.6% and 57.8% of the patients, respectively. Intima-media thickening (intima-media thickness > 0.9 mm) was detected in 86.3% while carotid artery atherosclerosis was detected in 53.0% of the patients. The majority (69.7%) of patients with osteopenia/osteoporosis suffered from coronary artery calcification. Patients with stable angina combined with osteopenia/osteoporosis were characterized by a higher degree of carotid atherosclerosis (> 50%, multiple atherosclerotic plaques). We found a direct correlation of the fracture risk by FRAX to intima-media thickness (r = 0.21; p = 0.035) and to the degree of coronary artery calcification (r = 0.24; p = 0.018). Conclusion. In male patients aged > 50 years with stable angina, low bone mineral density and elevated fracture risk by FRAX are associated with increased carotid intima-media thickness, severe carotid atherosclerosis, and coronary artery calcification.

ишемическая болезнь сердца, каротидный атеросклероз, кальциноз, остеопороз, риск переломов, coronary artery disease, carotid atherosclerosis, calcinosis, osteoporosis, risk of fractures

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