Mammography for the diagnosis of heart disease
The data obtained by researchers working under the guidance of Professor Harvey Hecht from the Mount Sinai Clinic indicate that routine mammography, widely used as a screening method for early detection of breast cancer, can also be a useful tool for identifying women at risk for developing heart disease.
The results of the study demonstrated the existence of a direct relationship between the amount of calcium in the walls of the mammary arteries, clearly visible on the results of digital mammography, and the degree of calcification of the walls of the coronary arteries. Calcification of the walls of the coronary arteries is considered an important risk factor for the development of diseases of the cardiovascular system and, apparently, the amount of calcium deposits in the walls of the arteries of the mammary gland is its equivalent or even more powerful prognostic factor.
A total of 292 women who underwent mammography and computed tomography of the breast during one year took part in the study. Of these, almost half (42.5%) had signs of calcification of the mammary arteries. Mammograms were analyzed by an independent radiologist who had no data on the results of analysis of calcification of the coronary arteries. In general, women with signs of calcification were older, had higher blood pressure and a higher incidence of chronic kidney disease. At the same time, there were fewer smokers among them. Women with confirmed diagnoses of cardiovascular diseases were excluded from the study. The level of calcification of the mammary arteries was assessed on a scale from 0 to 12 as the severity increased, and the level of calcification of the coronary arteries was assessed according to the results of computed tomography using a validated 12-point scale of severity.
In 70% of women with signs of calcification of the arteries of the mammary gland, calcification of the coronary arteries was detected, while in 63% of women with calcification of the coronary arteries, calcium deposits in the arteries of the mammary gland were detected.
Processing of the collected data using multivariate analysis methods showed that the degree of calcification of the mammary arteries is no less a strong prognostic risk factor for the development of diseases of the cardiovascular system than the Framingham Risk Score, which often underestimates the level of risk for women, and recommendations for assessing cholesterol levels using group equations for the last of the adopted recommendations (2013 Cholesterol Guidelines Pooled Cohort Equations), quite often overestimating the risk.
When the researchers added data on 33 symptom-free women with established calcification of the mammary arteries to the analysis, this parameter turned out to be more powerful than both of the risk assessment formulas mentioned above. Thus, the presence of subclinical atherosclerosis may be a more important indicator of the risk of developing heart disease than other known risk factors.
The authors note that this information is available on mammography results and does not require additional radioactive radiation. It can be used to identify women at risk and timely preventive measures. However, they also note that larger clinical trials are needed to further confirm the results. Since women who have undergone both mammography and computed tomography according to clinical indications took part in this work, there is an increased probability that they have any concomitant diseases, although not related to diseases of the cardiovascular system.
The results of the work will be presented at the 65th Annual scientific session and exhibition of the American College of Cardiology, which will be held on April 2-4 in Chicago.
Article by Laurie Margolies et al. Digital Mammography and Screening for Coronary Artery Disease is published in the journal JACC: Cardiovascular Imaging.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru Based on the materials of the American College of Cardiology: Study Finds Routine Mammography May be Useful For Heart Disease Screening.
01.04.2016