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Association of breast arterial calcification with stroke and angiographically proven coronary artery disease

a meta-analysis

Jiang, Xuezhi MD, FACOG, NCMP1,2; Clark, Maureen BS1; Singh, Rupali K. MD1; Juhn, Alex BA1; Schnatz, Peter F. DO, FACOG, FACP, NCMP1,2,3,4

doi: 10.1097/GME.0000000000000300
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Objective We conducted a meta-analysis of the current literature to deduce the strength of association between breast arterial calcification (BAC) and coronary artery disease (CAD) and/or stroke.

Methods PubMed, Google Scholar, ClinicalTrials.gov, and Ovid were searched for English-language literature up to August 2013 using the terms “breast arterial calcification,” “breast vascular calcification,” “coronary artery disease,” “coronary heart disease,” “cardiovascular disease,” “abnormal coronary angiography,” and “stroke.” A hand search of the reference lists of key articles was performed to supplement the literature search. Our literature search revealed 75 articles for further abstract review. Limiting our search to articles that quantitatively assessed the correlation between BAC and stroke or angiographically proven CAD, we reviewed 35 full manuscripts. Of these articles, 14 were included in the final analysis.

Results We analyzed 10 cross-sectional studies (n = 3,952) with CAD as the primary outcome (diagnosed by coronary angiography). The odds ratio (95% CI) for CAD in those with BAC versus those without BAC is 3.86 (3.25-4.59) (P < 0.0001). For stroke, six cross-sectional studies were analyzed (n = 18,888). The odds ratio (95% CI) for stroke in those with BAC versus those without BAC is 1.54 (1.25-1.90) (P < 0.0001).

Conclusions These results suggest that BAC is significantly associated with both CAD and stroke. Although more prospective studies are warranted to clarify whether BAC is truly a predictor of the future development of CAD and stroke, the concept that BAC is a benign finding is waning.

From the 1Department of ObGyn, Reading Hospital, Reading, PA; 2Department of ObGyn, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA; 3Department of Internal Medicine, Reading Hospital, Reading, PA; and 4Department of Internal Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA.

Received March 6, 2014; revised and accepted May 29, 2014.

This paper was presented as an oral presentation at the 24th annual meeting of The North American Menopause Society, Dallas, TX, October 9 to 12, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Xuezhi Jiang, MD, FACOG, NCMP, Department of ObGyn R1, Reading Hospital, PO Box 16052, Reading, PA 19612-6052. E-mail: daniel.jiang@readinghealth.org

© 2015 by The North American Menopause Society.