Tedeschi Sara K, Hayashi Keigo, Guan Hongshu, Solomon Daniel H, Weber Brittany
Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA.
Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA.
Rheumatology (Oxford). 2025 May 1;64(5):2836-2841. doi: 10.1093/rheumatology/keae655.
Calcium pyrophosphate deposition (CPPD) disease is associated with an increased risk for cardiovascular (CV) events. We examined the atherosclerotic burden by coronary artery calcium (CAC) scores (Agatston score) and compared 10-year atherosclerotic CV disease (ASCVD) risk scores in patients with vs without chondrocalcinosis, a radiographic marker of CPPD.
We performed a cross-sectional analysis at an academic medical centre, 1991-2022. Among all patients with an Agatston score in routine care, we defined a cohort with chondrocalcinosis detected before the CAC scan. Comparators without chondrocalcinosis were matched 2:1 on age and sex-the primary analysis excluded statin users. We compared Agatston scores between the chondrocalcinosis cohort and comparators. We also tested for differences between cohorts in 10-year ASCVD risk score frequencies (low, borderline/intermediate or high).
756 patients with chondrocalcinosis were matched to 1554 comparators (mean age 68 years, 53% female). CV risk factor burden was high in both cohorts, and statin use was infrequent. The unadjusted Agatston score was non-significantly higher in the chondrocalcinosis cohort (mean 359.1, s.d. 737.9) than in matched comparators (mean 297.1, s.d. 644.9) (P = 0.08). High 10-year ASCVD risk scores were significantly more common in the chondrocalcinosis cohort than comparators (P < 0.01).
Coronary atherosclerosis burden by CAC was not significantly different between patients with chondrocalcinosis and matched comparators, though 10-year ASCVD risk scores were higher in the chondrocalcinosis cohort, suggesting that factors beyond coronary artery calcification contribute to the increased CV event rate in patients with CPPD disease.
焦磷酸钙沉积（CPPD）病与心血管（CV）事件风险增加相关。我们通过冠状动脉钙化（CAC）评分（阿加斯顿评分）检查动脉粥样硬化负担，并比较有与没有软骨钙质沉着症（CPPD的一种影像学标志物）的患者的10年动脉粥样硬化性心血管疾病（ASCVD）风险评分。
我们于1991年至2022年在一家学术医疗中心进行了横断面分析。在所有常规护理中有阿加斯顿评分的患者中，我们定义了一个在CAC扫描前检测到软骨钙质沉着症的队列。没有软骨钙质沉着症的对照者按年龄和性别以2:1进行匹配——主要分析排除了他汀类药物使用者。我们比较了软骨钙质沉着症队列与对照者之间的阿加斯顿评分。我们还测试了两个队列在10年ASCVD风险评分频率（低、临界/中等或高）方面的差异。
756例有软骨钙质沉着症的患者与1554例对照者匹配（平均年龄68岁，53%为女性）。两个队列的心血管危险因素负担都很高，他汀类药物使用不频繁。软骨钙质沉着症队列的未调整阿加斯顿评分（平均359.1，标准差737.9）略高于匹配的对照者（平均297.1，标准差644.9）（P = 0.08）。软骨钙质沉着症队列中10年ASCVD高风险评分显著比对照者更常见（P < 0.01）。
有软骨钙质沉着症的患者与匹配的对照者之间，通过CAC评估的冠状动脉粥样硬化负担没有显著差异，尽管软骨钙质沉着症队列的10年ASCVD风险评分更高，这表明冠状动脉钙化以外的因素导致了CPPD病患者心血管事件发生率增加。
