Register
Forgot your password?

The relationship between lipid, calciumand phosphorus metabolism, severety of coronaryartery lesions and osteopenia in elderly patientswith coronary artery disease

Authors: Barbarash O.L.1,2, 2, Kashtalap V.V.1,2, 2, Zykov M.V.1, Khryachkova O.N.1, Novitskaya A.A.1, Kokov A.N.1, Shibanova I.A.1, Raskina T.A.2

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases; Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
2 Kemerovo State Medical Academy of Ministry of Health of the Russian Federation; ulitsa Voroshilova, 22a, Kemerovo, 650029, Russian Federation

For correspondence:  Sign in or register.

Type:  Heart valve and coronary artery calcification


DOI: https://doi.org/10.15275/kreatkard.2016.02.02

For citation: Barbarash O.L., Kashtalap V.V., Zykov M.V. et al. The relationship between lipid, calcium and phosphorus metabolism, severety of coronary artery lesions and osteopenia in elderly patients with coronary artery disease. Kreativnaya Kardiologiya. 2016; 10 (2): 117-127 (in Russian)

Keywords: coronary atherosclerosis coronary artery disease calcification dyslipidemia osteopenic syndrome hypogonadism

Download
Full text:  

 

Abstract

Objective. To identify the relationship between the severity of coronary atherosclerosis, coronary calcification, osteopenic syndrome and functional parameters of bone metabolism and dyslipidemia in elderly patients with stable coronary artery disease (CAD).

Material and methods. 57 elderly male patients (the median age of 65 [62; 69] years) with stable CAD were included in the study. The severity of coronary atherosclerosis and coronary artery calcification was assessed by the number of significant coronary artery lesions and SYNTAX score; multislice computed tomography (MSCT) with the quantitative analysis of coronary calcification and the measurement of the coronary artery calcium score by the Agatston method (CaScore); the presence of osteopenic syndrome was diagnosed by dual energy X-ray absorptiometry; the severity of dyslipidemia and bone metabolism disorders were assessed using blood serum analysis.

Results. Reduced bone mineral density was associated with the severity of coronary atherosclerosis assessed by the SYNTAX score and quantitative parameters of coronary artery calcification (CaScore). The relationship between biomarkers of bone metabolism disorders, lipid profile and coronary artery calcification scores has not been observed. However, patients with severe atherosclerosis demonstrated higher osteopontin levels. A tendency to elevated estradiol levels in patients with severe coronary atherosclerosis, assessed by the SYNTAX score, has been found.

Conclusion. The correlation between reduced bone mineral density and the severity of coronary atherosclerosis and calcification has been found in elderly male patients with stable CAD. Metabolic correlates of osteopenic syndrome and coronary atherosclerosis have been identified.

References

  1. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia. J. Clin. Lipidol. 2013; 6 (7): 561–5.
  2. Boekholdt S.M., Hovingh G.K., Mora S., Arsenault B.J., Amarenco P., Pedersen T.R. et al. Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: a meta-analysis of statin trials. JACC. 2014; 5 (64): 485–94.
  3. Marcovitz P.A., Tran H.H., Franklin B.A., O'Neill W.W., Yerkey M., Boura J. et al. Userfulness of bone mineral density to predict significant coronary artery disease. Am. J. Cardiol. 2005; 96 (8): 1059–63.
  4. Cooper C., Melton L.J., III. Epidemiology of osteoporosis. Trends Endocrinol. Metab. 1992; 3: 224–9. 5. Prevention and Management of Osteoporosis. Report of a WHO Technical Report Series. Geneva: WHO; 2003: 921.
  5. Barbarash O.L., Lebedeva N.B., Kokov A.N., Novitskaya A.A., Khryachkova O.N., Voronkina A.V. et al. The relationship of biochemical markers of bone metabolism, osteopenic syndrome and coronary atherosclerosis in men with stable coronary heart disease. Ateroskleroz. 2015; 11 (2): 5–13 (in Russian).
  6. Watts N.B., Adler R.A., Bilezikian J.P., Drake M.T., Eastell R., Orwoll E.S. et al. Osteoporosis in men: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Met. 2012; 97 (6): 1802–22.
  7. Browner W.S., Sooley D.G., Vogt T.M. Non-trauma mortality in elderly women with low bone mineral density. Lancet. 1991; 338: 335–8.
  8. Tsarenok S.Y., Gorbunov V.V. The levels of osteoprotegerin, transforming growth factor-β, and some cytokines in women with coronary heart disease concurrent with osteoporosis. Terapevticheskiy arkhiv. 2015; 9: 39–43 (in Russian).
  9. Pahmani F., Garfinkel A., Demer L.L. Role of lipids in osteoporosis. Arterioscler. Thromb. Vasc. Biol. 2000; 20: 2346–8.
  10. Scatena M., Liaw L., Giachelli C.M. Osteopontin. A multifunctional molecule regulating chronic inflammation and vascular disease. Arterioscler. Thromb. Vasc. Biol. 2007; 27: 2302–9.
  11. Dalal S., Zha Q., Daniels C.R., Steagall R. J., Joyner W.L., Gadeau A.-P. et al. Osteopontin stimulates apoptosis in adult cardiac myocytes via the involvement of CD44 receptors, mitochondrial death pathway, and endoplasmic reticulum stress. Am. J. Physiol. Heart Circ. Physiol. 2014; 306 (8): 1182–91.
  12. Han X., Wang L-Y., Diao Z.-L., Liu W.-H. Apelin: a novel inhibitor of vascular calcification in chronic kidney disease. Atherosclerosis. 2016; 244: 1–8.
  13. Akiyoshi T., Ota H., Iijima K., Son B.-K., Kahyo T., Setou M. et al. A novel organ culture model of aorta for vascular calcification. Atherosclerosis. 2016; 244: 51–8.
  14. Hu X., Rui L., Zhu T., Xia H., Yang X., Wang X. et al. Low testosterone level in middle-aged male patients with coronary artery disease. Eur. J. Intern. Med. 2011; 22: e133–6.
  15. Larina V.N., Mikhaylusova M.P., Raspopova T.N. Biochemical markers of bone turnover in clinical practice. Lechebnoe delo. 2015; 2: 10–4 (in Russian).
  16. Wong N.D., Kouwabunpat D., Vo A.N., Detrano R.C., Eisenberg H., Goel M. et al. Coronary calcium and atherosclerosis by ultrafast computed tomography in asymptomatic men and women: relation to age and risk factors. Am. Heart J. 1994; 127: 422–30.
  17. Goel M., Wong N.D., Eisenberg H., Hagar J., Kelly K., Tobis J. M. et al. Risk factor correlates of coronary calcium as evaluated by ultrafast computed tomography. Am. J. Cardiol. 1992; 70: 977–80.
  18. Tanenbaum S.R., Kondos G.T., Veselik K.E., Prendergast M.R., Brundage B.H., Choomka E.V. Detection of calcific deposits in coronary arteries by ultrafast computed tomography and correlation with angiography. Am. J. Cardiol. 1989; 63: 870–2.
  19. Agatston A.S., Janowitz W.R., Hildner F.J., Zusmer N.R., Viamonte M., Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J. Am. Coll. Cardiol. 1990; 15: 827–32.
  20. Mintz G.S., Popma J.J., Pichard A.D., Kent K.M., Satler L.F., Chuang Y.C. et al. Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions. Circulation. 1995; 91: 1959–65.
  21. Tuzcu E.M., Berkalp B., De Franco A.C., Ellis S.G., Goormastic M., Whitlow P.L. et al. The dilemma of diagnosing coronary calcification: angiography versus intravascular ultrasound. J. Am. Coll. Cardiol. 1996; 27: 832–8.
  22. Sangiorgi G., Rumberger J.A., Severson A., Edwards W.D., Gregoire J., Fitzpatrick L.A. et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J. Am. Coll. Cardiol. 1998; 31: 126–33.
  23. Kelly-Arnold A., Maldonado N., Laudier D., Aikawa E., Cardoso L., Weinbaum S. Revised microcalcification hypothesis for fibrous cap rupture in human coronary arteries. Proc. Natl. Acad. Sci. USA. 2013; 110: 10741–6.
  24. Virmani R., Kolodgie F.D., Burke A.P., Farb A., Schwartz S.M. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler. Thromb. Vasc. Biol. 2000; 20: 1262–75.
  25. Burke A.P., Weber D.K., Kolodgie F.D., Farb A., Taylor A.J., Virmani R. Pathophysiology of calcium deposition in coronary arteries. Herz. 2001; 26: 239–44.
  26. Savage M.P., Goldberg S., Hirshfeld J.W., Bass T.A., MacDonald R.G., Margolis J.R. et al. Clinical and angiographic determinants of primary coronary angioplasty success. M-HEART Investigators. J. Am. Coll. Cardiol. 1991; 17: 22–8.
  27. Tan K., Sulke N., Taub N., Sowton E. Clinical and lesion morphologic determinants of coronary angioplasty success and complications: current experience. J. Am. Coll. Cardiol. 1995; 25: 855–65.
  28. Fitzgerald P.J., Ports T.A., Yock P.G. Contribution of localized calcium deposits to dissection after angioplasty. An observational study using intravascular ultrasound. Circulation. 1992; 86: 64–70.
  29. Richardson P.D., Davies M.J., Born G.V. Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet. 1989; 2: 941–4.
  30. Detre K.M., Holmes D.R., Jr., Holubkov R., Cowley M.J., Bourassa M.G., Faxon D.P. et al. Incidence and consequences of periprocedural occlusion. The 1985–1986 National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Circulation. 1990; 82: 739–50.
  31. Nobuyoshi M., Kimura T., Ohishi H., Horiuchi H., Nosaka H., Hamasaki N. et al. Restenosis after percutaneous transluminal coronary angioplasty: pathologic observations in 20 patients. J. Am. Coll. Cardiol. 1991; 17: 433–9.
  32. Osswald B., Blackstone E., Tochtermann U., Schweiger P., Thomas G., Vahl C.F. et al. Does the completeness of revascularization affect early survival after coronary artery bypass grafting in elderly patients? Eur. J. Cardiothorac. Surg. 2001; 20: 120–6.
  33. Nakayama Y., Sakata R., Ura M., Miyamoto T.A. Coronary artery bypass grafting in dialysis patients. Ann. Thorac. Surg. 1999; 68: 1257–61.

About Authors

  • Barbarash Ol’ga Leonidovna, MD, DM, Professor, Director of Research Institute for Complex Issues of Cardiovascular Diseases, Chief of Chair;
  • Kashtalap Vasiliy Vasil’evich, MD, DM, Chief of Laboratory, Associate Professor;
  • Zykov Mikhail Valer’evich, MD, PhD, Research Associate;
  • Khryachkova Oksana Nikolaevna, Junior Research Associate;
  • Novitskaya Anastasiya Aleksandrovna, Cardiologist;
  • Kokov Aleksandr Nikolaevich, MD, PhD, Chief of Laboratory;
  • Shibanova Irina Aleksandrovna, MD, PhD, Senior Research Associate;
  • Raskina Tat'yana Alekseevna, MD, DM, Professor, Chief of Chair

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by