Breast Arterial Calcifications on Mammography Do Not Predict Myocardial Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography

Ahmed Fathala; Salma Salem; Fahad Alanazi; Deema Abunayyan; Abdelmoneim M Eldali; Abdulaziz Alsugair

doi:10.14740/cr604w

Breast Arterial Calcifications on Mammography Do Not Predict Myocardial Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography

Cardiol Res. 2017 Oct;8(5):220-227. doi: 10.14740/cr604w. Epub 2017 Oct 27.

Authors

Ahmed Fathala¹, Salma Salem¹, Fahad Alanazi¹, Deema Abunayyan¹, Abdelmoneim M Eldali², Abdulaziz Alsugair¹

Affiliations

¹ Department of Radiology, Nuclear Medicine and Cardiovascular Imaging, King Faisal Specialist Hospital & Research Center, PO Box 3354, Riyadh, Saudi Arabia.
² Research Centre, Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, PO Box 3354, Riyadh, Saudi Arabia.

PMID: 29118884
PMCID: PMC5667709
DOI: 10.14740/cr604w

Abstract

Background: The aim of this study was to determine if breast arterial calcification (BAC) on mammography predicts myocardial ischemia (MI) on stress myocardial perfusion single-photon emission computed tomography (MPS). BAC is a type of medial artery calcification that can be seen incidentally on mammography, but the relationship between coronary artery calcification and MI on MPS is yet unknown.

Methods: A total of 435 consecutive women underwent mammography and stress MPS within 1 year of each other. BAC was quantitatively evaluated (0 - 13). Patients with known coronary artery diseases (CADs) such as coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), MI, positive coronary angiogram or positive MPS were excluded from the study. Risk factors for CAD were obtained from a chart review.

Results: The mean age was 58 ± 8 years. BAC was found in 258 (59%) of the study population. BAC-positive patients were significantly older than BAC-negative patients (P < 0.0001), there were strong associations between BAC and hypertension (P = 0.0309), chronic kidney disease (CKD) (P = 0.0001), and diabetes (P = 0.0309), but there were significant associations between BACV and hyperlipidemia, family history of CAD, and smoking (P = 0.6856, P = 0.9642, and P = 0.087, respectively). The mean score of BAC was 5 ± 5 in patients with normal MPS and was 6 ± 6 in patients with abnormal MPS. There were no associations between total BAC and MPS results (P = 0.2095), and between BAC categories and MPS result (P = 0.3069).

Conclusions: Based on our study, the presence and severity of BAC on screening or diagnostic mammography do not predict MI on stress MPS, and further cardiac workup based on the presence of BAC is not warranted. BAC is very common in mammography up to 59% and associated with age, diabetes, CKD, and hypertension. In contrast, the prevalence of MI is only 13% in women with BAC and associated with age, diabetes, CKD, hyperlipidemia, and impaired left ventricular function.

Keywords: Breast calcification; CAD; Myocrdial ischmeia.