Coronary microvascular endothelial dysfunction is an independent predictor of development of osteoporosis in postmenopausal women
Authors Prasad M, Reriani M, Khosla S, Gössl M, Lennon R, Gulati R, Prasad A, Lerman L, Lerman A
Received 5 March 2014
Accepted for publication 3 April 2014
Published 26 August 2014 Volume 2014:10 Pages 533—538
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Megha Prasad, Martin Reriani, Sundeep Khosla, Mario Gössl, Ryan Lennon, Rajiv Gulati, Abhiram Prasad, Lilach O Lerman, Amir Lerman
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
Background: A growing body of evidence links coronary artery atherosclerosis and calcification to osteoporosis in women. The endothelium plays a critical role in maintaining vascular integrity and may play a role in bone metabolism. We aimed to determine whether early coronary atherosclerosis, as detected by coronary microvascular endothelial dysfunction (CMED), predicts the development of osteoporosis in postmenopausal women.
Methods: Coronary vascular reactivity was evaluated in 194 postmenopausal women greater than 50 years of age and with non-obstructive coronary arteries by administration of intracoronary acetylcholine during diagnostic angiography. CMED was defined as ≤50% increase in coronary blood flow from baseline in response to maximal dose. After a median follow-up of 7.0±0.3 years, patients were assessed by a questionnaire for development of osteoporosis.
Results: The average age of the cohort was 60.9±7.4 years. Women with CMED were twice as likely to develop osteoporosis compared with women without endothelial dysfunction after adjustment for potential confounders (relative risk, 2.4; 95% confidence interval [CI], 1.1, 5.6, P=0.02). Epicardial endothelial dysfunction was not associated with development of osteoporosis.
Discussion: Early coronary atherosclerosis with endothelial dysfunction is an independent marker for increased risk of developing osteoporosis in postmenopausal women greater than 50 years of age without obstructive coronary artery disease. The current study supports a link between coronary atherosclerosis and osteoporosis.
Keywords: coronary artery disease, endothelial dysfunction, endothelial progenitor cells, low bone mass, screening
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