title: Association between serum alkaline phosphatase and coronary artery calcification in a sample of primary cardiovascular prevention patients.
abstract: A high level of serum alkaline phosphatase (ALP) is associated with an increased risk of mortality and myocardial infarction. ALP hydrolyses inorganic pyrophosphate, which is a strong inhibitor of calcium phosphate deposition. The aim of this study was to determine whether ALP is associated with the coronary artery calcium score (CACS).
  
  
  
  We examined the association of CACS, assessed by computed tomography scanning, and ALP, in 500 patients consecutively recruited, free of cardiovascular disease. The CACS were categorized into two groups: no calcification (CACS = 0) (n = 187) and with calcification (CACS>0) (n = 313). ALP activity was divided into three tertile groups: low ALP level (<55 IU/L), intermediate (55-66 IU/L) and high ALP level (>66 IU/L).
  
  
  
  The mean age was 60.9 ± 10.8 years, 49.6% of the patients were women. ALP ranged from 22 to 164 IU/L (mean 62.6 IU/L, SD 19.3). In univariate analysis, traditional cardiovascular risk factors, statin use (p = 0.001), and ALP (p = 0.001) were significantly associated with CACS. After adjusting for cardiovascular risk factors, only age (p = 0.001) and sex (p = 0.001) were independently associated with CACS. Compared to the tertile group with low levels of ALP, the intermediate tertile group [OR 2.11, 95% CI (1.12; 3.96), p = 0.02], as well as the high tertile group [OR 3.89, 95% CI (2.01; 7.54), p = 0.001)], was independently associated with CACS.
  
  
  
  In patients free of cardiovascular disease, high ALP levels are positively and independently associated with coronary artery calcification. The metabolic pathway of ALP and inorganic pyrophosphate could be a target for new therapies against vascular calcification.
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Panh
authors.affiliation: Department of Epidemiology, Unité de Soutien Méthodologique à la Recherche (USMR), Toulouse University Hospital (CHU), 37 Allées Jules Guesde, 31073 Toulouse Cedex 7, France.
authors.forename: Jean Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.affiliation: Department of Radiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.affiliation: Department of Radiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Petermann
authors.affiliation: Department of Epidemiology, Unité de Soutien Méthodologique à la Recherche (USMR), Toulouse University Hospital (CHU), 37 Allées Jules Guesde, 31073 Toulouse Cedex 7, France.
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.affiliation: Department of Epidemiology, Unité de Soutien Méthodologique à la Recherche (USMR), Toulouse University Hospital (CHU), 37 Allées Jules Guesde, 31073 Toulouse Cedex 7, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bérard
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Dorota
authors.initials: D
authors.lastname: Taraszkiewicz
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lairez
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Department of Cardiology, Toulouse-Rangueil University Hospital (CHU), TSA 50032, Toulouse University School of Medicine, 1 Avenue du Professeur Jean Poulhes, 31059 Toulouse Cedex 9, France. Electronic address: jean.ferrieres@univ-tlse3.fr.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000517:prevention & control; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000201:enzymology* / Q000517:prevention & control; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000097:blood* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000469:Alkaline Phosphatase
keywords: Alkaline phosphatase; Calcification; Coronary artery disease; Statin