USA: The intake of oral calcium supplements may lead to serial coronary artery calcification, find a recent study in the journal JACC: Cardiovascular Imaging. The study found an association between oral calcium supplementation and increased calcium deposition in the coronary vasculature.
Calcium supplements are prescribed frequently for the treatment or prevention of bone-related disorders. While bone benefits of calcium supplementation appear notionally valid their cardiovascular safety remains controversial. Also, their effects on serial coronary calcification are not well determined. Considering this, Najdat Bazarbashi, Cleveland Clinic, Cleveland, Ohio, and colleagues sought to evaluate and assess the extent of serial coronary artery calcification in response to oral calcium supplementation.
The study was a post hoc patient-level analysis of 9 prospective randomized trials. The researchers compared changes in serial percentage of atheroma volume (PAV) and calcium indices (CaI) using serial coronary intravascular ultrasound in matched segments of patients coronary artery disease who were receiving concomitant calcium supplements (n = 447) and in those who did not receive supplements (n = 4,700) during an 18- to 24-month trial period.
Key findings of the study include:
Patients (mean age 58 ± 9 years; 73% were men; 43% received concomitant high-intensity statins) demonstrated overall annualized changes in PAV and CaI with a mean of −0.02 ± 1.9% (p = 0.44) and a median of 0.02 from baseline, respectively.
Following propensity-weighted mixed modeling adjusting for treatment and a range of demographic, clinical, ultrasonic, and laboratory parameters (including but not limited to sex, race, baseline, and annualized change in PAV, baseline CaI, concomitant high-intensity statins, diabetes mellitus, renal function), there were no significant between-group differences in annualized changes in PAV (least-squares mean: 0.09 vs. 0.01) according to calcium supplement intake.
Per a multivariable logistic regression model accounting for the range of covariates described, calcium supplementation independently associated with an increase in annualized CaI (odds ratio: 1.15).
"Oral calcium supplementation may increase calcium deposition in the coronary vasculature independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes requires further investigation," concluded the authors.
The study titled, "Oral Calcium Supplements Associate With Serial Coronary Calcification: Insights From Intravascular Ultrasound," is published in the journal JACC: Cardiovascular Imaging.
DOI: https://www.jacc.org/doi/10.1016/j.jcmg.2020.06.030