title: Coronary artery calcification is inversely related to body morphology in patients with significant coronary artery disease: a three-dimensional intravascular ultrasound study.
abstract: OBJECTIVE
  Emerging data have indicated unexpected complexity in the regulation of vascular and bone calcification. In particular, several recent studies have challenged the concept of a universally positive relationship between body morphology [weight, height, body mass index (BMI), body surface area (BSA)] and the extent of vascular calcification. We sought to clarify these discrepancies and investigated the relationship between index lesion coronary artery calcification (CAC) and body morphology in patients undergoing percutaneous coronary intervention (PCI) using three-dimensional intravascular ultrasound (IVUS).
  
  
  RESULTS
  We analysed CAC in patients who underwent PCI with pre-intervention IVUS imaging. The main outcome measure was the calcium index (CalcIndex); a three-dimensional IVUS-derived measure of total calcification per obstructive coronary lesion. A total of 346 patients (65.3 ± 10.6 years; 29.5% females) underwent PCI with IVUS-based CAC assessment. CalcIndex was categorized as zero-low (0-0.1399; n = 152) or intermediate-high (0.1400-1.2541; n = 194). All measures of body morphology were lower in patients with intermediate-high CalcIndex (height, P = 0.024; weight, P = 0.008; BMI, P = 0.064; BSA, P = 0.005). In adjusted multivariable models, weight and BSA were independent inverse predictors of intermediate-high CalcIndex [weight: odds ratio (OR) 0.986, P = 0.017; BSA: OR 0.323, P = 0.012] while CalcIndex also trended towards an inverse association with both height (P = 0.068) and BMI (P = 0.064). These independent inverse associations were consistent across multiple clinical subgroups, including stratification by age, race, gender, diabetes, and renal impairment.
  
  
  CONCLUSIONS
  Using three-dimensional IVUS to assess vascular calcification, these data confirm an independent, inverse relationship between body size and index lesion CAC in patients with obstructive coronary artery disease.
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.forename: Solene M
authors.initials: SM
authors.lastname: Evrard
authors.forename: Samantha
authors.initials: S
authors.lastname: Sartori
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Li
authors.forename: Amala P
authors.initials: AP
authors.lastname: Chirumamilla
authors.forename: Aya
authors.initials: A
authors.lastname: Nomura-Kitabayashi
authors.forename: Nilusha
authors.initials: N
authors.lastname: Gukathasan
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hassanin
authors.forename: Usman
authors.initials: U
authors.lastname: Baber
authors.forename: Martin
authors.initials: M
authors.lastname: Fahy
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Jason C
authors.initials: JC
authors.lastname: Kovacic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
keywords: Body surface area; Obesity; Vascular calcification; Weight
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