Coronary Artery Disease Association With Arterial Calcifications on Routine Hand Radiographs.

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Citation: Journal of Hand Surgery - American Volume. 44(12):1060-1065, 2019 Dec.PMID: 31677909Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Coronary Artery Disease/di [Diagnosis] | *Hand/bs [Blood Supply] | *Hand/dg [Diagnostic Imaging] | *Vascular Calcification/dg [Diagnostic Imaging] | Adult | Aged | Aged, 80 and over | Coronary Angiography | Exercise Test | Female | Humans | Male | Middle Aged | Retrospective Studies | Risk FactorsYear: 2019Local holdings: Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - presentISSN:
  • 0363-5023
Name of journal: The Journal of hand surgeryAbstract: CONCLUSIONS: The current data demonstrate that arterial calcifications on hand radiographs are independently associated with CAD. This may represent an opportunity to the treating physician as a point of referral or investigation for underlying or occult CAD.METHODS: A record review from a single institution identified 345 patients with both hand radiographs and CAD screening with cardiac stress testing or coronary angiography. Patients with chronic kidney disease, end-stage renal disease, or incomplete hand films were excluded. We reviewed x-rays for findings of arterial calcifications. Cardiac testing results were used to establish a baseline diagnosis of CAD. We made group comparisons and employed multivariable logistic regression to evaluate the association between upper-extremity calcification and CAD.PURPOSE: Arterial calcifications in the lower extremity, chest, and cardiac vessels have been linked to coronary artery disease (CAD). However, the relation between arterial calcifications observed on routine hand and upper-extremity radiographs and atherosclerosis has not been determined. This study examined whether arterial calcifications found on hand radiographs are associated with CAD.RESULTS: A total of 210 patients met inclusion criteria: 155 with CAD and 55 without it. Mean age was 72 years, body mass index was 28.8, and 54% were male. Patients had comorbidities of hypertension (91%), hyperlipidemia (87%), diabetes (39%), cerebrovascular accident (9%), and a history of tobacco use (53%). Of 155 CAD patients, 67 had arterial calcifications on hand radiographs (43%), compared with 6 of 55 without it (11%). In a multivariable model controlling for sex, hyperlipidemia, and diabetes, the presence of arterial calcifications on hand plain films indicated a 6.2-fold increased odds of CAD.TYPE OF STUDY/LEVEL OF EVIDENCE: Prevalence III. Copyright (c) 2019 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.All authors: Giladi AM, Hall EC, Iorio ML, Ruan Q, Taylor EM, Wu WWOriginally published: Journal of Hand Surgery - American Volume. 2019 Oct 30Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-11-19
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31677909 Available 31677909

Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present

CONCLUSIONS: The current data demonstrate that arterial calcifications on hand radiographs are independently associated with CAD. This may represent an opportunity to the treating physician as a point of referral or investigation for underlying or occult CAD.

METHODS: A record review from a single institution identified 345 patients with both hand radiographs and CAD screening with cardiac stress testing or coronary angiography. Patients with chronic kidney disease, end-stage renal disease, or incomplete hand films were excluded. We reviewed x-rays for findings of arterial calcifications. Cardiac testing results were used to establish a baseline diagnosis of CAD. We made group comparisons and employed multivariable logistic regression to evaluate the association between upper-extremity calcification and CAD.

PURPOSE: Arterial calcifications in the lower extremity, chest, and cardiac vessels have been linked to coronary artery disease (CAD). However, the relation between arterial calcifications observed on routine hand and upper-extremity radiographs and atherosclerosis has not been determined. This study examined whether arterial calcifications found on hand radiographs are associated with CAD.

RESULTS: A total of 210 patients met inclusion criteria: 155 with CAD and 55 without it. Mean age was 72 years, body mass index was 28.8, and 54% were male. Patients had comorbidities of hypertension (91%), hyperlipidemia (87%), diabetes (39%), cerebrovascular accident (9%), and a history of tobacco use (53%). Of 155 CAD patients, 67 had arterial calcifications on hand radiographs (43%), compared with 6 of 55 without it (11%). In a multivariable model controlling for sex, hyperlipidemia, and diabetes, the presence of arterial calcifications on hand plain films indicated a 6.2-fold increased odds of CAD.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prevalence III. Copyright (c) 2019 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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