The correlation of SYNTAX score by coronary angiography with breast arterial calcification by digital mammography

Abstract

Aim: To evaluate the hypothesis that breast arterial calcification (BAC) may predict coronary artery disease (CAD) severity. Materials and methods: The study comprised 102 women >45 years (mean age 62±8 years) referred for digital mammography after coronary angiography. BAC was assessed using the Likert scale and CAD severity was assessed using the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery trial) score. Results: In comparison to the low SYNTAX score group (≤22) patients with a intermediate-to-high SYNTAX score (>22) were older (p=0.001), they more often had hypercholesterolaemia (p<0.001), diabetes (p=0.021), and a history of smoking (p=0.048). They also had a statistically higher level of fasting blood glucose (p<0.001), glycated haemoglobin (HbA1C; p<0.001), triglycerides (p=0.002), fibrinogen (p=0.001), whereas high-density lipoprotein (HDLc) was lower than in the group with a SYNTAX score ≤22 (p=0.005). BAC was significantly higher in patients with a SYNTAX score >22 (p<0.001). At multivariate analysis, BAC (odds ratio [OR] 34.24, 95% confidence interval [CI]: 8.05–145.7, p<0.001), hypercholesterolaemia (OR 22.65, 95% CI: 4.18–122.81, p<0.001) and fibrinogen (OR 2.55, 95% CI: 1.28–5.07, p=0.008) were independent predictive factors for patients with intermediate-to-high SYNTAX score. Conclusions: In women >45 years, there was a significant correlation between the severity of CAD as evaluated by the SYNTAX score and BAC as evaluated by the Likert scale. BAC, hypercholesterolaemia, and fibrinogen may be used as an additional diagnostic tool to predict the presence and severity of CAD. © 2017 The Royal College of Radiologists