The correlation between osteoporosis, fracture risk and the risk of adverse cardiovascular events according to the novel SCORE2/SCORE2-OP scale in postmenopausal females

Abstract Introduction Low bone mineral density (BMD) observed in osteoporosis (OP) may be related to the risk of cardiovascular diseases (CVD). Recent European Society of Cardiology guidelines proposed the updated SCORE2 / SCORE2-OP (Systemic Coronary Risk Estimation) algorithms to estimate the 10-year risk of fatal/non-fatal CV episodes. Purpose We aimed to study the relationship between OP, OP-related fractures and CVD risk assessed by the new algorithm. Material and Methods A total of 103 pts (postmenopausal female, mean age 69 +/- 7), consulted by endocrinologist, was divided into 2 groups according to BMD (assessed by dual energy X-ray absorptiometry). BMD measurements expressed as T-score (T-sc) were taken from femoral neck (T-sc Neck), entire total hip (T-sc TH) and/or spine (T-sc L2-L4, L1-L4). We compared 51 pts with OP (T-sc ≤ -2.5), with 52 matched controls without OP, including 44 pts with osteopenia (T-sc -2.5). Exclusion criteria included heart failure NYHA II and/or LVEF 36%, acute coronary syndrome within the last 6 months, severe valvular disease, cardiac implantable electronic device. There were no significant differences between the groups regarding stroke, myocardial infarction, coronary artery disease, and arterial hypertension. CVD risk was assessed by SCORE2/SCORE2-OP in version for high-risk regions. Major osteoporotic and total hip fracture risks (respectively: MOFR, THFR) were assessed by the FRAX scale. Results There was a significant negative correlation between SCORE2-OP and T-sc Neck (r=-0.28, p=0.04), T-sc TH (r=-0.28, p=0.04), and a significant positive correlation between SCORE2-OP and MOFR (r=0.32, p=0.02), THFR (r=0.4, p=0.003) in the entire study group. Additionally, significant positive correlations were found between THFR and SCORE2-OP in the OP group (r=0.46, p=0.02), and THFR and SCORE2 (r=0.45, p=0.02) in the control group. Conclusions The risk of fatal or non-fatal cardiovascular events according to the novel SCORE2-OP calculator is negatively correlated with BMD assessed at femoral neck and total hip. SCORE2-OP risk estimates are also significantly linked with the risk of total hip fracture and major osteoporotic fracture.FRAX THFR and SCORE2OP correlation