SERUM-CALCIUM, PHOSPHORUS AND ALBUMIN LEVELS IN RELATION TO THE ANGIOGRAPHIC SEVERITY OF CORONARY-ARTERY DISEASE

Though calcium plays an important role in a number of biologic process es related to the pathogenesis of atherosclerosis, the relationship of serum calcium and phosphorus levels with the angiographic severity of coronary artery disease (CAD) is not known. We retrospectively studie d 376 stable patients (age range 31-86 years, mean 59.2+/-10.5 years; 68% males) undergoing routine coronary angiography and related the ang iographic severity of CAD with the serum levels of total and corrected calcium, phosphorus, albumin, total protein and bicarbonate. The prim ary variable studied was the number of vessels with haemodynamically s ignificant disease. On univariate analysis, total serum calcium and se rum albumin levels had a negative association with the number of vesse ls diseased (P=0.046 and 0.057, respectively). Multiple regression ana lysis using age, sex, smoking, diabetes, hypertension, hyperlipidaemia , ethnicity and family history, in addition to serum calcium, phosphor us and albumin levels as the predictor variables, showed that serum al bumin has an independent negative and serum phosphorus has an independ ent positive association with the angiographic severity of CAD (P=0.04 and 0.003, respectively; n=293). Serum phosphorus level also showed h ighly significant positive associations with the presence of total or subtotal occlusion and with most severe stenosis observed on angiograp hy. A moderate change in the serum level of albumin or phosphorus conf ers a risk similar to that associated with smoking, as estimated by th e odds ratios. (C) 1997 Elsevier Science Ireland Ltd.