LAUSR

Objectives To assess severity of atherosclerotic lesions of carotid arteries (CA) in men with coronary heart disease (CHD) depending on bone mineral density (BMD) and risk of osteoporotic fractures according to FRAX scale. Methods The study involved 102 men aged 51–75 years (median age of 6155; 65 with CHD, verified by coronary angiography method. All patients underwent dual energy X-ray absorptiometry of lumbar vertebral bodies LI-LIV and femoral neck and colour duplex scanning of extracranial arteries. Assessment of severity of carotid atherosclerosis was carried out by presence of atherosclerotic plaques (ASP) and stenosis of CA, thickness of intima-media (TIM) CA. Threshold TIM for men over age of 50 was considered 0.9 mm (recommendations of American Society of Echocardiography, 2008 Based on results of densitometry value of T-criterion (recommendations ISCD, 2007 men were divided into three groups: 33 patients with osteoporosis (OP, T-criterion ≤2.5), 48 patients with osteopenia (OPE, T–criterion of −1 to −2.5) and 21 men with normal BMD (NBMD, T-criterion ≥–1). On the basis of information on the presence of clinical risk factors of osteoporotic fractures and densitometry data at all included in the study patients FRAX calculator was used to quantify probability of major osteoporotic fractures and hip fracture in next 10 years. Results It was found that 86.3% of patients value TIM exceeds threshold value (0.9 mm). Thickening of intima-media complex was in men with OP in 88.0% of cases, with OPE – in 87.5%, with NBMD – in 81.0% without statistically significant differences (p>0.05). In a comparative analysis of atherosclerotic lesions CA found that men with OP significantly were more likely to have ASP in CA (75.8%) compared to patients with OPE (43.7%, p=0.010) and NBMD (38.1%, p=0.016). Stenosis of CA in all investigated men was discovered in 54 cases (53%). Comparative analysis showed that in patients with OP percentage of patients with stenosis of CA was 2 times more than men with NBMD (75.8% vs 38.1%, p=0.006) and was significantly higher than proportion of such patients in the group with OPE (44.0%, p=0.004). In all included the study patients 10 year absolute risk of major osteoporotic fracture by FRAX was equal to 9.88±7.22, risk of hip fracture – 3.97±6.27. There was inverse correlation of TIM with T–criterion (r=–0.21, p=0.035) and with BMD (r=−0.20, p=0.045) at level of hip and reliable direct correlation between TIM and risk of hip fracture by FRAX (r=0.21, p=0.035). Conclusions In men with CHD aged over 50 years low BMD (T–criterion is less than 2.5) is associated with more severe carotid atherosclerosis, and thickening of intima-media CA - with an increased risk of hip fracture. Disclosure of Interest None declared