Kelly Brendan S, ScanlON Emer, Heneghan Helen, Redmond Ciaran E, Healy Gerard M, Mc Dermott Enda, Heffernan Eric J, Prichard Ruth, Mc Nally Sorcha
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.
School of Medicine and Medical Science, UCD, Belfield D4, Ireland.
Clin Imaging. 2018 May-Jun;49:48-53. doi: 10.1016/j.clinimag.2017.10.021. Epub 2017 Nov 3.
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.
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.
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.
BAC diagnosed on 2 yearly screening mammography predicts CAD-RADs ≥3 disease in symptomatic patients.
数字化乳腺钼靶摄影中的乳腺动脉钙化（BAC）与冠状动脉疾病（CAD）风险增加有关。我们旨在调查在国家乳腺筛查项目的女性队列中，BAC与冠状动脉计算机断层扫描血管造影（CCTA）结果之间的关联。
记录了2014年至2015年间接受CCTA且同时进行了乳腺筛查钼靶摄影的50至65岁有症状（胸痛）女性。BAC和CAD-RADS™：冠状动脉疾病报告和数据系统由不同的 blinded 专科放射科医生进行评分。记录心脏危险因素。还记录了患者的心脏随访情况（通过运动负荷试验、经皮冠状动脉介入治疗或超声心动图）以及心脏保护药物的使用情况。
219名符合条件的女性接受了CCTA。其中，104名患者还接受了数字化乳腺钼靶摄影。使用标准线性回归分析，BAC被确定为CAD-RADs≥3级疾病的显著预测因子。使用二项逻辑回归分析，BAC仍与CAD-RADs≥3相关（p = 0.023）。在平均随访20.6（范围15 - 27）个月后，与无BAC的患者相比，BAC>1的患者中使用心脏保护药物的比例显著更高（p = 0.041），并且开始或更改药物治疗，或进行进一步心脏检查的比例也更高（分别为p = 0.037和p = 0.019）。
在两年一次的筛查乳腺钼靶摄影中诊断出的BAC可预测有症状患者的CAD-RADs≥3级疾病。
