Electrocardiogram abnormalities and coronary calcification in postmenopausal women

An electrocardiogram [ECG] can provide information on subclinical myocardial damage. The presence, and more importantly the quantity of coronary artery calcification [CAC], relates well with the overall severity of the atherosclerotic process. A strong relation has been demonstrated between coronary calcium burden and the incidence of myocardial infarction, a relation independent of age. The aim of this study was to assess the relation of left ventricular hypertrophy [LVH] and ECG abnormalities with CAC. The study population comprised 566 postmenopausal women selected from a population-hated cohort study. Information on LVH and repolarization abnormalities [T-axis and QRS-T angle] was obtained using electrocardiography Modular ECG Analysis System [MEANS] was used to assess ECG abnormalities. The women underwent a multi detector-row computed tomography [MDCT] scan [Philips Mx 8000 IDT 16] to assess CAC. The Agatston score was used to quantify CAC; scores greater than zero were considered as the presence of coronary calcium. Logistic regression was used to assess the relation of ECG abnormality with coronary calcification. LVH was found in 2.7% [n = 15] of the women. The prevalence of T-axis abnormality was 6% [n = 34], whereas 8.5% [n = 48] had a QRS-T angle abnormality. CAC was found in 62% of the women. Compared to women with a normal T-axis, women with borderline or abnormal T-axes were 3.8 fold more likely to have CAC [95% CI: 1.4-10.2]. Similarly compared to women with a normal QRS-T angle, in women with borderline or abnormal QRS-T angle, CAC was 2.0 fold more likely to be present [95% CI: 1.0-4.1]. Among women with ECG abnormalities reflecting subclinical ischemia, CAC is commonly found and may in part explain the increased coronary heart disease risk associated with these ECG abnormalities

Cardiovascular risk factors and specific coronary artery calcification in postmenopausal women

Myocardial infractions at different locations have been related to different sets of risk factors. This study was designed to examine the association between cardiovascular risk factors and specific coronary artery calcification [CAC]. The study population comprised 573 postmenopausal women selected from a population-based cohort study. Established vascular risk factors were measured. The women underwent a multi detector-row computed tomography [16-MDCT] [Philips Mx 8000 IDT 16] to assess coronary calcium. The Agatston score was used to quantify coronary calcium. Logistic regression models were utilized to assess the relations. The prevalence of coronary artery calcification [Agatston score >0] was 61.5% [n= 348]. CAC was most common in the left anterior descending [LAD] artery with a prevalence of 43.9%; and the rates of prevalence in the right coronary arter [RCA], the circumflex [LCX], the left main artery [LM], and the posterior descending artery [PDA] were 23.1%, 19.4%, 15.8%, and 0.3%, respectively. In the multivariate regression models, age was predominantly related to the calcification in the LAD and LCX, low density lipoprotein to calcification in the LAD, and cholesterol to the calcification of the RCA. Hypertension and systolic and diastolic blood pressure were related to the calcification of the LCX, whereas smoking was predominantly related to the calcification of both LAD and RCA. Finally, age, body mass index, and systolic blood pressure were significantly related to teh classification in the LM. Our findings showed that the consequences of elevated risk factor levels on the development of atherosclerosis appeared to be different across the segments of the coronary arteries