ArticleFrontiers in cardiovascular medicine2026
Correlation between calcium levels and coronary microvascular disease in high-altitude environments: nested case-control study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Coronary microvascular disease (CMVD) is an emerging concern under high-altitude hypoxia, but data on modifiable correlates are scarce. Serum calcium regulates vascular tone and coagulation, making it a plausible candidate marker. However, its association with CMVD at high altitude has not been systematically examined. Methods: This nested case-control study enrolled 1,175 participants undergoing high-altitude training at 3,000-3,500 m. Participants were classified into CMVD and non-CMVD groups based on electrocardiogram (ECG) screening and coronary flow reserve (CFR ≤ 2.3) confirmed by transthoracic Doppler echocardiography. Cases ( Results: Serum calcium levels were significantly higher in the CMVD group than in the non-CMVD group [2.42 (2.32-2.47) vs. 2.37 (2.31-2.42) mmol/L, Conclusion: In this nested case-control sample of high-altitude trainees, higher serum calcium levels were significantly associated with an increased prevalence of CMVD. These findings suggest that serum calcium may serve as a potential screening indicator for CMVD in high-altitude settings.
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