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Association between lower extremity arterial calcification and coronary arterial calcification in a population at increased risk of cardiovascular disease.
- Source :
-
BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2024 Feb 08; Vol. 12 (1). Date of Electronic Publication: 2024 Feb 08. - Publication Year :
- 2024
-
Abstract
- Introduction: There is conflicting evidence whether lower extremity arterial calcification coincides with coronary arterial calcification (CAC). The aims of this study were to investigate the associations between (1) femoral and crural calcification with CAC, and (2) femoral and crural calcification pattern with CAC.<br />Research Design and Methods: This cross-sectional study included 405 individuals (74% men, 62.6±10.9 years) from the ARTEMIS cohort study at high risk of cardiovascular disease (CVD) who underwent a CT scan of the femoral, crural and coronary arteries. High CVD risk was defined as history/presence of cerebrovascular disease, coronary artery disease, abdominal aortic aneurysm, renal artery stenosis, peripheral artery disease or CVD risk factors: diabetes mellitus type 2, hypertension, hyperlipidemia. Calcification score within each arterial bed was expressed in Agatston units. Dominant calcification patterns (intimal, medial, absent/indistinguishable) were determined via a CT-guided histologically validated scoring algorithm. Multivariable-adjusted multinomial logistic regression analyses were used. Replication was performed in an independent population of individuals with diabetes mellitus type 2 (Early-HFpEF cohort study).<br />Results: Every 100-point increase in femoral and crural calcification score was associated with 1.23 (95% CI=1.09 to 1.37, p<0.001) and 1.28 (95% CI=1.11 to 1.47, p=0.001) times higher odds of having CAC within tertile 3 (high) versus tertile 1 (low), respectively. The association appeared stronger for crural versus femoral arteries. Moreover, the presence of femoral intimal (OR=10.81, 95% CI=4.23 to 27.62, p<0.001), femoral medial (OR=10.37, 95% CI=3.92 to 27.38, p<0.001) and crural intimal (OR=6.70, 95% CI=2.73 to 16.43, p<0.001) calcification patterns were associated with higher odds of having CAC within tertile 3 versus tertile 1, independently from concomitant calcification score. This association appeared stronger for intimal versus medial calcification patterns. The replication analysis yielded similar results.<br />Conclusions: Higher femoral and crural calcification scores were associated with higher CAC. Moreover, the presence of femoral intimal, femoral medial and crural intimal calcification patterns was associated with increased CAC. It appears that arterial calcification is a systemic process which occurs simultaneously in various arterial beds.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Male
Humans
Female
Coronary Vessels pathology
Cohort Studies
Cross-Sectional Studies
Risk Factors
Stroke Volume
Lower Extremity
Cardiovascular Diseases
Vascular Calcification diagnostic imaging
Vascular Calcification epidemiology
Vascular Calcification pathology
Heart Failure
Diabetes Mellitus, Type 2 complications
Subjects
Details
- Language :
- English
- ISSN :
- 2052-4897
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMJ open diabetes research & care
- Publication Type :
- Academic Journal
- Accession number :
- 38336383
- Full Text :
- https://doi.org/10.1136/bmjdrc-2023-003811