Breast arterial calcification and carotid arteries atherosclerotic load in women

Abstract

Aim. To develop a diagnostic complex (DC) of ultrasound markers characterizing carotid arteries (CA) atherosclerotic load, and to evaluate its association with breast arterial calcification (BAC) in women.Material and methods. The cross-sectional case-control study included 198 women aged 40-74 years, who made up of 2 groups of 99 participates in each, with or without BAC, who underwent diagnostic digital mammography. The study protocol included physical examination, medical history, questionnaires, laboratory tests, electrocardiography, carotid ultrasound. BAC severity was assessed on a 12-point scale. Ultrasound parameters of CA atherosclerotic load were assessed: the number of atherosclerotic plaques, maximum, total and average stenosis. All patients signed informed consent to participate in the study.Results. Atherosclerotic plaques were detected in 79.9% of women with BAC and in 60.6% of women without BAC. The best statistically significant difference in both groups was found in the "number of atherosclerotic plaques", "average stenosis" and "maximum stenosis", on the basis of which the DC in points was formed. When comparing the average DC value, it was found that the degree of atherosclerotic load is statistically significantly higher in women with calcification (p=0.001). There was a significantly higher proportion of people with BAC in the groups of women with both DC values >2 points (p<0.001) and DC >0 points (p=0.022). Univariate analysis showed that with a DC >2 points, the probability of having BAC in women increases by 4.06 times (95% CI: 1.92-9.25; p<0.001). Menopause (p=0.024), osteoporosis (p=0.013), glomerular filtration rate <90 ml/min/1.73 m2 (p=0.004), thyroid disease (p=0.041) and hormone replacement therapy for hypothyroidism (p=0.015) were associated with BAC. As a result of multivariate analysis, significant associations of BAC with DC >2 points (OR=2.87; p=0.012) and hormone replacement therapy for hypothyroidism (OR=0.31; p=0.017) were found. There was no statistically significant relationship between DC and the severity of BAC on a 12-point scale.Conclusion. A DC was developed to assess the degree of CA atherosclerotic load. Differences in DC parameters were revealed between groups of women with and without BAC: DC>2 points increase the chance of having BAC. The demonstrated connection between BAC and asymptomatic CA atherosclerosis indicates the prospects for using this form of vascular calcification as a gender-specific marker of cardiovascular diseases in women.

Keywords

• breast arterial calcification
• mammography
• atherosclerotic load
• carotid arteries
• diagnostic complex