Diagnostic Performance of Breast Arterial Calcification for Detecting Coronary Artery Calcification in Women with Chronic Kidney Disease
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Abstract
Background: Arterial calcification is common in patients with chronic kidney disease (CKD) and contributes substantially to cardiovascular morbidity and mortality. Breast arterial calcification (BAC), which occurs exclusively in arterial media, may serve as a surrogate marker of coronary artery calcification (CAC) in CKD.
Methods: This cross-sectional study included 103 women aged >40 years who underwent digital mammography, lateral lumbar spine x-ray for abdominal aortic calcification (AAC), and non-contrast CT for coronary artery calcification (CAC). The BAC score was calculated based on the number of calcified breast arteries, the maximum length of calcification, and calcification density.
Results: BAC severity increases with advancing CKD stage. In multivariable analysis, adjusting for traditional cardiovascular risk factors, BAC was independently associated with reduced kidney function and older age. In patients with advanced CKD, BAC demonstrated high sensitivity (85.7%) and moderate accuracy (67.6%) for detecting CAC. Both BAC and AAC scores were significantly associated with CAC, with area under the curve (AUC) values of 0.67 and 0.84, respectively. The combined BAC and AAC model showed improved predictive performance for CAC (AUC 0.88).
Conclusions: Combined BAC and AAC provide good predictive performance for CAC, supporting the potential role of BAC as a noninvasive surrogate marker of vascular calcification burden in female patients with CKD.
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