Key result
Higher BSA linked to ~68% lower likelihood of intermediate-high coronary calcification.
Why the study?
Recent studies have challenged the concept of a universally positive relationship between body morphology and vascular calcification, necessitating clarification of these discrepancies.
Is body morphology inversely related to coronary artery calcification in patients with significant coronary artery disease undergoing PCI?
Observational (n=346)
Is body morphology inversely related to coronary artery calcification in patients with significant coronary artery disease undergoing PCI?
Odds Ratio: 0.986
p-value: p=0.017
In patients with obstructive CAD undergoing PCI, body size (weight and BSA) is independently and inversely associated with the extent of coronary artery calcification assessed by 3D IVUS.
Inverse body size-CAC association in PCI patients is hypothesis-generating; leaves open causal role and clinical relevance pending longitudinal data.
AIMS: Emerging data have indicated unexpected complexity in the regulation of vascular and bone calcification. In particular, several recent studies have challenged the concept of a universally positive relationship between body morphology [weight, height, body mass index (BMI), body surface area (BSA)] and the extent of vascular calcification. We sought to clarify these discrepancies and investigated the relationship between index lesion coronary artery calcification (CAC) and body morphology in patients undergoing percutaneous coronary intervention (PCI) using three-dimensional intravascular ultrasound (IVUS). METHODS AND RESULTS: We analysed CAC in patients who underwent PCI with pre-intervention IVUS imaging. The main outcome measure was the calcium index (CalcIndex); a three-dimensional IVUS-derived measure of total calcification per obstructive coronary lesion. A total of 346 patients (65.3 ± 10.6 years; 29.5% females) underwent PCI with IVUS-based CAC assessment. CalcIndex was categorized as zero-low (0-0.1399; n = 152) or intermediate-high (0.1400-1.2541; n = 194). All measures of body morphology were lower in patients with intermediate-high CalcIndex (height, P = 0.024; weight, P = 0.008; BMI, P = 0.064; BSA, P = 0.005). In adjusted multivariable models, weight and BSA were independent inverse predictors of intermediate-high CalcIndex [weight: odds ratio (OR) 0.986, P = 0.017; BSA: OR 0.323, P = 0.012] while CalcIndex also trended towards an inverse association with both height (P = 0.068) and BMI (P = 0.064). These independent inverse associations were consistent across multiple clinical subgroups, including stratification by age, race, gender, diabetes, and renal impairment. CONCLUSION: Using three-dimensional IVUS to assess vascular calcification, these data confirm an independent, inverse relationship between body size and index lesion CAC in patients with obstructive coronary artery disease.
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Dangas et al. (2013) conducted an observational in Obstructive coronary artery disease (n=346). Body morphology (weight, body surface area) was evaluated on Intermediate-high calcium index (CalcIndex 0.1400-1.2541) (OR 0.986, p=0.017). Higher body weight and body surface area were independently associated with a lower likelihood of intermediate-high coronary artery calcification (weight OR 0.986, P=0.017; BSA OR 0.323, P=0.012).
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