Study: Bone x-ray can predict aortic calcification in women

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Images obtained on bone densitometers for vertebral fracture assessment (VFA) can predict abdominal aortic calcification (AAC) in post-menopausal, Caucasian women, according to research findings published online on Oct. 22 in the Journal of Bone and Mineral Research.

“Previous work has shown that it is cost-effective to do VFA scans in many postmenopausal women to detect vertebral fracture, and prescribe osteoporosis treatment medication when such a vertebral fracture is seen. This study indicates that physicians should use the opportunity of a VFA scan to look for evidence of cardiovascular disease” said lead author, John Scho, MD, Park Nicollet Health Services in Minneapolis, Minn. “This is particularly important in women, since two-thirds of women who die suddenly of coronary heart disease have no prior symptoms.”

In a randomized, controlled study of clodronate versus placebo, researchers examined women 75 years and older who sustained a heart attack or stroke. During the median four year follow-up study period, 408 women were selected as cases, and 408 controls were randomly selected from the remainder of the parent study population. Investigators used single-energy vertebral fracture assessment (VFA) exams to measure abdominal aortic calcification shown on lateral spine images. 

“This study found that AAC had a similar predictive strength for cardiovascular disease (CVD) as the Framingham Point score. The Framingham Point score combines the traditional risk factors of total cholesterol, HDL, blood pressure, hypertension treatment and smoking to predict 10-year cardiovascular heart disease risk” said co-author Eugene McCloskey, MD, Sheffield University, United Kingdom. “Additionally, we found that this predictive ability of AAC was independent of all of the traditional cardiovascular disease (CVD) risk factors we collected in the study.”

The study concluded that “a high level of abdominal aortic calcification detected on VFA images is predictive of incident myocardial infarction or stroke among elderly Caucasian women, independent of other clinical CVD risk factors. Since bone densitometry is indicated for all women age 65 and older, VFA imaging offers an opportunity to capture this CVD risk factor in post-menopausal women undergoing bone densitometry at very little additional cost.”

The study took place at a WHO-collaborating Metabolic Bone Centre at Northern General Hospital in Sheffield, United Kingdom. The participants were recruited from general practitioner’s lists in the South Yorkshire and North Derbyshire in the United Kingdom.