Lack of association of oral calcium supplementation with coronary artery calcification in rheumatoid arthritis

Laura Geraldino-Pardilla, Shanthi Dhaduvai, Jon T. Giles, Joan M. Bathon

Research output: Contribution to journalArticle

Abstract

Objective To investigate the association between oral calcium supplementation and coronary artery calcification among rheumatoid arthritis (RA) patients without known cardiovascular disease (CVD). Methods This study was conducted as a nested, prospective cohort study of RA patients without known CVD. The daily supplemental calcium dose was ascertained from each patients' list of prescription and over-the-counter medications at baseline and at visit 2 (median 20 months postbaseline). The coronary artery calcium (CAC) score, a measure of coronary atherosclerosis, was assessed by cardiac multidetector row computed tomography at baseline and at visit 3 (median 39 months postbaseline). The association between calcium supplementation and CAC was explored. Results Among the 145 RA patients studied, 42 (28%) were taking ≥1,000 mg/day of supplemental calcium at baseline. A CAC score of >100 units was seen in 44 patients (30%) at baseline and 50 patients (34%) at followup. Baseline CAC scores of >100 units were significantly less frequent in patients receiving the higher dosage (≥1,000 mg/day) of supplemental calcium than in those receiving the lower dosage (100 units were less frequent in the higher supplemental calcium dose group compared to the lower dose group (OR 0.41, 95% CI 0.18-0.95); however, after adjustment for relevant confounders, the statistical significance of this association was lost (adjusted OR 0.39, 95% CI 0.14-1.12). No effect of sex heterogeneity was seen in the association of calcium supplementation with coronary artery calcification, and no change in the CAC score over time was observed. Conclusion Higher levels of oral calcium supplementation were not associated with an increased risk of coronary atherosclerosis, as measured by the CAC score, in this RA cohort.

Original languageEnglish (US)
Pages (from-to)1465-1473
Number of pages9
JournalArthritis and Rheumatology
Volume67
Issue number6
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

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Rheumatoid Arthritis
Coronary Vessels
Calcium
Coronary Artery Disease
Cardiovascular Diseases
Multidetector Computed Tomography
Prescriptions
Cohort Studies
Prospective Studies

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology

Cite this

Lack of association of oral calcium supplementation with coronary artery calcification in rheumatoid arthritis. / Geraldino-Pardilla, Laura; Dhaduvai, Shanthi; Giles, Jon T.; Bathon, Joan M.

In: Arthritis and Rheumatology, Vol. 67, No. 6, 01.06.2015, p. 1465-1473.

Research output: Contribution to journalArticle

Geraldino-Pardilla, Laura ; Dhaduvai, Shanthi ; Giles, Jon T. ; Bathon, Joan M. / Lack of association of oral calcium supplementation with coronary artery calcification in rheumatoid arthritis. In: Arthritis and Rheumatology. 2015 ; Vol. 67, No. 6. pp. 1465-1473.
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abstract = "Objective To investigate the association between oral calcium supplementation and coronary artery calcification among rheumatoid arthritis (RA) patients without known cardiovascular disease (CVD). Methods This study was conducted as a nested, prospective cohort study of RA patients without known CVD. The daily supplemental calcium dose was ascertained from each patients' list of prescription and over-the-counter medications at baseline and at visit 2 (median 20 months postbaseline). The coronary artery calcium (CAC) score, a measure of coronary atherosclerosis, was assessed by cardiac multidetector row computed tomography at baseline and at visit 3 (median 39 months postbaseline). The association between calcium supplementation and CAC was explored. Results Among the 145 RA patients studied, 42 (28{\%}) were taking ≥1,000 mg/day of supplemental calcium at baseline. A CAC score of >100 units was seen in 44 patients (30{\%}) at baseline and 50 patients (34{\%}) at followup. Baseline CAC scores of >100 units were significantly less frequent in patients receiving the higher dosage (≥1,000 mg/day) of supplemental calcium than in those receiving the lower dosage (100 units were less frequent in the higher supplemental calcium dose group compared to the lower dose group (OR 0.41, 95{\%} CI 0.18-0.95); however, after adjustment for relevant confounders, the statistical significance of this association was lost (adjusted OR 0.39, 95{\%} CI 0.14-1.12). No effect of sex heterogeneity was seen in the association of calcium supplementation with coronary artery calcification, and no change in the CAC score over time was observed. Conclusion Higher levels of oral calcium supplementation were not associated with an increased risk of coronary atherosclerosis, as measured by the CAC score, in this RA cohort.",
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