Nearly 80% of patients with lung cancer had detectable atherosclerosis on their cancer staging CT scans and other cardiovascular risk factors were common, offering an opportunity for earlier cardiac testing and risk factor modification, according to a new study presented at ACC's Advancing Cardiovascular Care for the Oncology Patient course, taking place Feb. 14-16, in Washington, DC, and virtually.

In this retrospective chart review of 276 patients with lung cancer at a single cancer center, researchers assessed staging CT scans taken near presentation for the presence of coronary or aortic atherosclerosis, as well as recorded cardiovascular risk factors.

Results showed that 77.9% of patients had atherosclerosis, and that tobacco use and age ≥65 years significantly increased the likelihood of atherosclerosis. Large cell and non-small cell squamous cell carcinoma were also associated with a higher presence of atherosclerosis compared to non-small cell adenocarcinoma and small cell lung cancers.

Among the patients, 47.8% of patients had systolic blood pressure ≥130 mm Hg and 38% had a diastolic blood pressure ≥80 mm Hg. Overall, 27.2% of participants were obese, and 88.8% were current or former tobacco users.

"Smoking was by far the most prominent cardiac risk factor in this group. This was followed by advancing age, hypertension and obesity," said Christopher Michael Malozzi, DO, FACC, lead author of the study and director of cardio-oncology services at the University of South Alabama Frederick P. Whiddon College of Medicine. "Recognition of cardiac risk factors and atherosclerosis allows for earlier treatment interventions and risk factor modification in these patients."

"This study suggests it may be reasonable to consider concurrent coronary calcium scoring on imaging obtained for lung cancer staging or screening to aid in identification of atherosclerosis and earlier intervention such as lifestyle, diet and cardiac risk factor modification education," Malozzi added. "The use of imaging already available may also reduce the need for additional testing in these patients and cut down overall health care costs."

A similar analysis using CT scans by the same study group found that atherosclerosis was present in nearly one-third of a cohort of patients with gynecological cancer entering treatment as well.

ACC's Advancing the Cardiovascular Care of the Oncology Patient course, led by Chair Richard Cheng, MD, MSc, FACC, and Vice Chair Anju Nohria, MD, MSc, is an interdisciplinary and inter-specialty conference designed to provide clinicians with the tools needed to improve the cardiovascular care of cancer patients in everyday practice. ACC President Cathleen Biga, MSN, FACC, will deliver a keynote on building a thriving cardio-oncology practice.

"The conference is packed with sessions designed to provide practical, actionable knowledge and foster patient-centered, evidence-based, collaborative care for individuals living with and beyond cancer," said Cheng.

Additional research from the conference on pulmonary tumor thrombotic microangiopathy was simultaneously published in JACC: Case Reports. Abstracts and posters presented also touched on:

• Left Ventricular Longitudinal Strain and Cardiotoxicity in Cancer Patients Treated with Anthracyclines
• In-Hospital Utilization of Palliative Care Services in Patients with Cardiac Amyloidosis
• Establishment of a Cardio-Oncology Clinic for the Implementation of the Cardio-Renal-Metabolic Profile Through Telemedicine in Mexican Breast Cancer Patients

Sessions focused on cardiovascular health in long-term cancer survivors, the use of artificial intelligence in precision imaging and the future of training and clinical practice for cardio-oncologists, and more.