Among patients who undergo coronary angiography because of chest pain, the prevalence of obstructive coronary artery disease is greater among those with osteoporosis or osteopenia compared to those with normal bone mineral density (BMD).

In a retrospective analysis, Dr. Wilbert S. Aronow and colleagues from New York Medical College, Valhalla, examined the association between osteoporosis and osteopenia with obstructive coronary artery disease.

They examined 198 consecutive patients who underwent dual-energy X-ray absorptiometry scans of the spine and left hip because of suspected osteoporosis or osteopenia. The bone scans were performed within six months of coronary angiography.

Of the 198 patients, 146 were women and 52 were men. The subjects had a mean age of 66 years. The results of the study are published in the April 15th issue of the American Journal of Cardiology.

Of the 198 subjects, 53 had osteoporosis, 79 had osteopenia, and 66 had normal BMD. Overall, 40 patients (76 per cent) with osteoporosis, 54 (68 per cent) with osteopenia, and 31 (47 per cent) with normal BMD had obstructive coronary artery disease with greater than 50 per cent narrowing of at least one major coronary artery. The mechanism of this association is unclear, the authors say.

The investigators note that none of the study participants were taking hormone replacement therapy. However, they observed a higher prevalence of the use of statins in patients with normal BMD (86 per cent) than in those with osteoporosis (70 per cent) or osteopenia (72 per cent).

"On the basis of the available data, patients with osteoporosis or osteopenia should have intensive treatment of modifiable risk factors for CAD," Dr. Aronow and colleagues conclude. "This therapy should include strong consideration of the use of statins."


Am J Cardiol 2008;101:1103-1104