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Mammograms may provide clues to heart-disease risk in older women

Circulation: Cardiovascular Imaging
Reuters Health - 15/03/2022 - Routine mammograms may provide important insights into cardiovascular disease (CVD) risk for older women.

In a new study researchers found that breast arterial calcifications seen on screening digital mammography was associated with a higher risk of CVD over roughly six years in postmenopausal women.

"We hope that our study will encourage an update of the guidelines for reporting breast arterial calcification from routine mammograms," Dr. Carlos Iribarren of Kaiser Permanente Northern California Division of Research in Oakland said in a news release.

"Our study has moved the needle toward recommending routine assessment and reporting of breast arterial calcification in postmenopausal women. Integrating this information in cardiovascular risk calculators and using this new information can help improve cardiovascular risk reduction strategies," Dr. Iribarren said.

The findings, published online in Circulation: Cardiovascular Imaging, are based on 5,059 women aged 60 to 79 years who had routine digital mammography screening between 2012 and 2015.

Breast arterial calcification (BAC) was present in 1,338 women 26.5% and absent in the remainder.

After a mean follow-up of 6.5 years, there were 155 (3.0%) atherosclerotic (AS)CVD events and 427 (8.4%) global CVD events.

After adjusting for traditional CVD risk factors, the presence of BAC was associated with a significantly increased risk of ASCVD (hazard ratio, 1.51; P=0.02) and a 23% increased risk of global CVD (HR, 1.23; P=0.04).

"There was no clear dose-response association of BAC with either ASCVD or global CVD when BAC was modeled using tertiles," the researchers report.

However, it could be that six years of follow-up is not enough time to provide a sufficient number of events for the dose-response association to emerge, they note. They did find a threshold effect for global CVD at very high BAC burden (95th percentile when BAC present).

"Further research in large cohorts with longer follow-up period is needed to better delineate the dose-response association between BAC burden and CVD outcomes and to establish the value of BAC in women before age 60," Dr. Iribarren and colleagues write.

The findings also suggest that BAC adds prognostic information for CVD at every level of the pooled-cohorts equation (PCE) risk.

"This implies that women with BAC at borderline or intermediate ASCVD risk may be candidates for more aggressive treatment, and women with BAC already at high risk may be candidates for intensification of therapy," the study team says.

Overall, the researchers say their study "adds to the body of evidence that assessment and reporting of BAC status has potential utility to change clinical practice and impact primary CVD prevention for women."

The study had no commercial funding and the authors have no relevant conflicts of interest.

SOURCE: https://bit.ly/34Np34U and https://bit.ly/34IHgjU Circulation: Cardiovascular Imaging, online March 15, 2022.

By Reuters Staff

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