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. 2022 Dec 12;10(12):3227.
doi: 10.3390/biomedicines10123227.

Relationship between Arterial Calcifications on Mammograms and Cardiovascular Events: A Twenty-Three Year Follow-Up Retrospective Cohort Study

Natalia González Galiano  1   2 , Noemi Eiro  2 , Arancha Martín  2   3 , Oscar Fernández-Guinea  4 , Covadonga Del Blanco Martínez  4 , Francisco J Vizoso  2   5
Affiliations

Relationship between Arterial Calcifications on Mammograms and Cardiovascular Events: A Twenty-Three Year Follow-Up Retrospective Cohort Study

Natalia González Galiano et al. Biomedicines. .

Abstract

Purpose: Breast arterial calcifications (BAC) have been associated with cardiovascular diseases. We aimed to examine whether the presence of BAC could predict the development of cardiovascular events in the very long term, as evidence has suggested.

Patients and methods: We conducted a 23-year follow-up retrospective cohort study considering women specifically studied for breast cancer. After reviewing the mammograms of 1759 women, we selected 128 patients with BAC and an equal number of women without BAC.

Results: Women with BAC had higher relative risk (RR) for cardiovascular events, globally 1.66 (95% CI): 1.31-2.10 vs. 0.53 (0.39-0.72), and individually for ischemic heart disease 3.25 (1.53-6.90) vs. 0.85 (0.77-0.94), hypertensive heart disease 2.85 (1.59-5.09) vs. 0.79 (0.69-0.89), valvular heart disease 2.19 (1.28-3.75) vs. 0.83 (0.73-0.94), congestive heart failure 2.06 (1.19-3.56) vs. 0.85 (0.75-0.96), peripheral vascular disease 2.8 (1.42-5.52) vs. 0.85 (0.76-0.94), atrial fibrillation 1.83 (1.09-3.08) vs. 0.86 (0.76-0.98), and lacunar infarction 2.23 (1.21-4.09) vs. 0.86 (0.77-0.96). Cox's multivariate analysis, also considering classical risk factors, indicated that this BAC was significantly and independently associated with survival (both cardiovascular event-free and specific survival; 1.94 (1.38-2.73) and 6.6 (2.4-18.4)).

Conclusions: Our data confirm the strong association of BAC on mammograms and the development cardiovascular events, but also evidence the association of BAC with cardiovascular event-free and specific survival.

Keywords: breast arterial calcifications; cardiovascular risk; cost effectiveness; mammograms; prevention; risk assessment.

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Conflict of interest statement

The author reports no conflict of interest in this work.

Figures

Figure 1
Figure 1
Mammogram showing breast arterial calcifications (rows).
Figure 2
Figure 2
Kaplan-Meier survival curves. (A) Kaplan-Meier cardiovascular events-free survival curve as a function of patients with or without BAC. Kaplan-Meier survival curve as a function of patients with or without BAC. (B) overall survival and (C) cardiovascular event-specific survival.
Figure 3
Figure 3
Overview of deceases and causes in patients with or without BAC. BAC: Breast arterial calcification, APE: Acute pulmonary edema; APTE: Acute pulmonary thromboembolism; IHD: Ischemic heart disease; CRA: Cardiorespiratory arrest.
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