Ahmadi N, et al. - Researchers explored the link between bone mineral density (BMD) levels and coronary artery calcium (CAC) and mortality in both genders across ethnicities. They noted an independent association of lower BMD levels with the severity of CAC that predicted mortality.

Methods

• In this study, experts assembled 5,590 consecutive at-risk subjects without known coronary artery disease (CAD), age 57 ± 12 and 69% male, who underwent non-enhanced cardiac computed tomography and followed them for mean of 8 years.
• They measured the subjects’ CAC (Agatston score) and thoracic BMD levels (mg/cm3).
• CAC stratified based on the severity to CAC 0, 1–100, 101–400, and 400+.
• Experts defined low-BMD levels as BMD levels below median (180 mg/cm<sup3).
• Physician verified that all-cause mortality was assessment hard-endpoint.
• To assess the relationship between BMD and CAC, multivariate regression analysis, adjusted for age, gender, and other cardiovascular risk factors, was used.

Results

• With the severity of CAC, BMD levels dropped proportionally (p < 0.05) in both genders, especially postmenopausal women.
• Low BMD levels independently predicted mortality, and event-free survival rate was 99% and 93% in those within normal BMD levels vs those with low BMD levels (p=0.0001).
• Also, experts found a significant link between low BMD levels and CAC > 0 with increased risk of mortality (p=0.0001).
• Results demonstrated that the relative risk of death was 2.8, 5.9, and 14.3-folds higher in CAC 1–100, 101–400, and 400+ with low BMD levels, vs CAC=0 and within normal BMD levels, respectively (p < 0.05).