Relation of Bone Mineral Density to Stress Test–Induced Myocardial Ischemia

• Published in: The American journal of cardiology Vol. 104; no. 2; pp. 199 - 201
• Main Authors: Pierre-Louis, Bredy, MD, Aronow, Wilbert S., MD, Yoon, Joo H., MD, Ahn, Chul, PhD, DeLuca, Albert J., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.07.2009; Elsevier; Elsevier Limited
• Subjects: Absorptiometry, Photon; Analysis of Variance; Biological and medical sciences; Bone Density; Cardiology; Cardiology. Vascular system; Cardiovascular; Chi-Square Distribution; Coronary heart disease; Exercise Test - adverse effects; Female; Health Status Indicators; Heart; Heart attacks; Humans; Investigative techniques, diagnostic techniques (general aspects); Ischemia; Logistic Models; Male; Medical sciences; Medical tests; Middle Aged; Myocardial Ischemia - epidemiology; Myocardial Ischemia - etiology; Myocardial Ischemia - physiopathology; Myocarditis. Cardiomyopathies; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis - complications; Osteoporosis - diagnostic imaging; Osteoporosis - physiopathology; Prevalence; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Regression analysis; Risk Factors; Stress; United States - epidemiology; Vascular disease; Cardiovascular disease; Myocardial ischemia; Bone mineral density; Circulatory system; Cardiology; Coronary heart disease; Myocardial disease; Stress
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.03.016

Dual-energy x-ray absorptiometric scans of the spine and left hip were performed before stress testing for myocardial ischemia in 629 women and 136 men (mean age 63 years) with chest pain and no previous coronary artery disease. Of the 765 patients, 254 (33%) had osteoporosis, 260 (34%) had osteopenia, and 251 (33%) had normal bone mineral density (BMD). Stress test–induced myocardial ischemia was present in 95 of 254 patients (37%) with osteoporosis, in 81 of 260 patients (31%) with osteopenia, and in 62 of 251 patients (25%) with normal BMD (p = 0.002 comparing osteoporosis with normal BMD and p = 0.007 comparing osteoporosis or osteopenia with normal BMD). Stepwise logistic regression analysis showed that patients with osteoporosis or osteopenia had a 1.7 times higher chance of stress test–induced myocardial ischemia than those with normal BMD after controlling the confounding effects of systemic hypertension, diabetes mellitus, body mass index, and age. In conclusion, patients with chest pain undergoing stress testing have a higher prevalence of stress test–induced myocardial ischemia if they have osteoporosis or osteopenia than if they have normal BMD.