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Abstract：
OBJECTIVE: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Breast arterial calcification (BAC) on mammograms is not associated with breast cancer risk. However, there is increasing evidence supporting its association with cardiovascular disease (CVD). This study examines the association between BAC and ASCVD and their risk factors within an Australian population-based breast cancer study.
METHODS: Data from the controls who participated in the breast cancer environment and employment study (BCEES) were linked with the Western Australian Department of Health Hospital Morbidity database and Mortality Registry to obtain ASCVD outcomes and related risk factor data. Mammograms from participants with no prior history of ASCVD were assessed for BAC by a radiologist. Cox proportional hazards regression was used to examine the association between BAC and later occurrence of an ASCVD event. Logistic regression was used to investigate the factors associated with BAC.
RESULTS: A total of 1020 women with a mean age of 60 (sd = 7.0 years) were included and BAC found in 184 (18.0%). Eighty (7.8%) of the 1020 participants developed ASCVD, with an average time to event of 6.2 years (sd = 4.6) from baseline. In univariate analysis, participants with BAC were more likely to have an ASCVD event (HR = 1.96 95% CI 1.29-2.99). However, after adjusting for other risk factors, this association attenuated (HR = 1.37 95% CI 0.88-2.14). Increasing age (OR = 1.15, 95% CI 1.12-1.19) and parity (pLRT < 0.001) were associated with BAC.
CONCLUSIONS: BAC is associated with increased ASCVD risk, but this is not independent of cardiovascular risk factors.
METHODS: Data from the controls who participated in the breast cancer environment and employment study (BCEES) were linked with the Western Australian Department of Health Hospital Morbidity database and Mortality Registry to obtain ASCVD outcomes and related risk factor data. Mammograms from participants with no prior history of ASCVD were assessed for BAC by a radiologist. Cox proportional hazards regression was used to examine the association between BAC and later occurrence of an ASCVD event. Logistic regression was used to investigate the factors associated with BAC.
RESULTS: A total of 1020 women with a mean age of 60 (sd = 7.0 years) were included and BAC found in 184 (18.0%). Eighty (7.8%) of the 1020 participants developed ASCVD, with an average time to event of 6.2 years (sd = 4.6) from baseline. In univariate analysis, participants with BAC were more likely to have an ASCVD event (HR = 1.96 95% CI 1.29-2.99). However, after adjusting for other risk factors, this association attenuated (HR = 1.37 95% CI 0.88-2.14). Increasing age (OR = 1.15, 95% CI 1.12-1.19) and parity (pLRT < 0.001) were associated with BAC.
CONCLUSIONS: BAC is associated with increased ASCVD risk, but this is not independent of cardiovascular risk factors.
摘要：
目的：动脉粥样硬化性心血管疾病（ASCVD）是发病和死亡的主要原因。乳房X线照片上的乳腺动脉钙化（BAC）与乳腺癌风险无关。然而,越来越多的证据支持其与心血管疾病(CVD)的相关性.这项研究在一项基于澳大利亚人群的乳腺癌研究中检查了BAC和ASCVD之间的关联及其危险因素。
方法：将参与乳腺癌环境和就业研究（BCEES）的对照组的数据与西澳大利亚州卫生部医院发病率数据库和死亡率登记相关联，以获得ASCVD结果和相关危险因素数据。放射科医生评估了没有ASCVD病史的参与者的乳房X线照片的BAC。Cox比例风险回归用于检查BAC与ASCVD事件后期发生之间的关联。采用Logistic回归分析探讨BAC的相关因素。
结果：共纳入了1020名平均年龄为60岁（sd=7.0岁）的女性，纳入了184名（18.0%）的BAC。1020名参与者中有80名（7.8％）患有ASCVD，事件发生的平均时间为距基线6.2年（sd=4.6）。在单变量分析中，BAC患者更有可能发生ASCVD事件(HR=1.9695%CI1.29~2.99).然而,在调整了其他风险因素后，这种关联减弱(HR=1.3795%CI0.88-2.14).年龄（OR=1.15，95％CI1.12-1.19）和产次（pLRT<0.001）与BAC相关。
结论：BAC与ASCVD风险增加相关，但这并非独立于心血管危险因素。
方法：将参与乳腺癌环境和就业研究（BCEES）的对照组的数据与西澳大利亚州卫生部医院发病率数据库和死亡率登记相关联，以获得ASCVD结果和相关危险因素数据。放射科医生评估了没有ASCVD病史的参与者的乳房X线照片的BAC。Cox比例风险回归用于检查BAC与ASCVD事件后期发生之间的关联。采用Logistic回归分析探讨BAC的相关因素。
结果：共纳入了1020名平均年龄为60岁（sd=7.0岁）的女性，纳入了184名（18.0%）的BAC。1020名参与者中有80名（7.8％）患有ASCVD，事件发生的平均时间为距基线6.2年（sd=4.6）。在单变量分析中，BAC患者更有可能发生ASCVD事件(HR=1.9695%CI1.29~2.99).然而,在调整了其他风险因素后，这种关联减弱(HR=1.3795%CI0.88-2.14).年龄（OR=1.15，95％CI1.12-1.19）和产次（pLRT<0.001）与BAC相关。
结论：BAC与ASCVD风险增加相关，但这并非独立于心血管危险因素。
