Prognostic significance of equivalent density of calcium deposits of coronary arteries in men with osteopenic syndrome and prior coronary artery bypass grafting: prospective study

Aim. Determination of the clinical and prognostic value of the equivalent density of calcium deposits (EDCD) of coronary arteries in patients with stable coronary heart disease (CHD) and concomitant osteopenic syndrome (OS) after coronary artery bypass grafting (CABG), based on five-year follow-up. Materials and methods. A prospective study included 393 patients with stable CHD hospitalized for CABG. All patients underwent multispiral computed tomography of coronary arteries to assess the degree of calcification and EDCD, and X-ray absorptiometry. During the five-year observation we studied mortality and adverse cardiovascular events. The average duration of the observation period was 58.9 +/- 1.8 months. Results. Data were obtained on the correlation of EDCD with the presence of OS (r=0.19; p<0.001), a decrease in the T-criterion of the thigh (r=-0.21; p<0.001) and lumbar vertebrae (r=-0.19; p<0.001). With a decrease in the EDCD of coronary arteries below the level of 0.19 mg/mm(3), an increased mortality risk is noted (odds ratio 2.84, 95% confidence interval 1.54-5.25). Linear regression analysis revealed that predictors of adverse outcomes over the course of a follow-up were the presence of carotid artery stenosis >= 30%, low left ventricular contractility, elevated triglyceride levels, and low EDCD. Conclusion. According to the results of the study the negative prognostic significance of the low EDCD of coronary arteries in relation to mortality, myocardial infarction, and revascularization in patients after CABG, regardless of the presence of concomitant OS.