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.
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.
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.
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.
Type of study/level of evidence
Prevalence III.
Key words
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Article info
Publication history
Published online: October 31, 2019
Accepted:
October 1,
2019
Received:
October 21,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
