Inflammatory Biomarkers Predictive of Coronary Artery Calcium in Women at Midlife Interview with:
Norman C. Wang, M.D., M.S., Assistant professor
University of Pittsburgh School of Medicine
Samar R. El Khoudary, Ph.D., M.P.H.,
Assistant professor of Epidemiology
University of Pittsburgh Graduate School of Public Health What is the background for this study? What are the main findings?

Response: We studied 252 middle-aged women with no known cardiovascular disease from the Study of Women’s Health Across the Nation [SWAN] Heart Study to determine if 5 blood biomarkers associated with abnormal inflammation/hemostasis were associated with increasing amounts of calcium detected in coronary arteries on computed tomography scans, or coronary artery calcium progression. Only higher blood levels of plasminogen activator inhibitor-1 was associated with coronary artery calcium progression. What should readers take away from your report?

Response: Increasing amounts of calcium in the coronary arteries are related to cardiovascular events later in life. Unfortunately, current therapies such as statins have failed to demonstrate the ability to decrease coronary artery calcium progression. Abnormalities in the fibrinolytic system may be related to increasing amounts of coronary artery calcium in middle-aged women undergoing the menopausal transition. Targeting this pathway may be a way to decrease coronary artery calcium progression and decrease CVD risk usually accompanies the menopausal transition. What recommendations do you have for future research as a result of this study?

Response: We recommend trials to assess if long-term blockade of the renin-angiotensin-aldosterone system, a hormonal system involved in blood pressure and fluid regulation, will decrease progression of coronary artery calcium. Prior studies have demonstrated that blocking this system can lower plasminogen activator inhibitor-1 levels. Is there anything else you would like to add?

Response: Our study only looked at black and white women, so the results are not generalizable to other racial or ethnic groups. We recommend testing to see if the associations demonstrated in our study are reproducible in other age, sex, and race/ethnic groups. If similar associations are present, additional studies with the aim to reduce calcium progression in participants with elevated plasminogen activator inhibitor-1 may be warranted. Additional researchers on the study are Karen A. Matthews, Ph.D., Emma J.M. Barinas-Mitchell, Ph.D., and Chung-Chou H. Chang, Ph.D., all of Pitt. The research was funded by the National Institutes of Health (NIH). Thank you for your contribution to the community.


Inflammatory/Hemostatic Biomarkers and Coronary Artery Calcium Progression in Women at Midlife (from the Study of Women’s Health Across the Nation [SWAN] Heart Study)
Wang, Norman C. et al.
American Journal of Cardiology , Published Online:May 14, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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