CAC May Help Determine Lung Cancer Patients’ Risk of CV Events During Radiation Treatment

Lung cancer patients with higher amounts of coronary artery calcium (CAC) may have an increased risk of an adverse cardiovascular event as a result of thoracic radiation therapy compared to patients with no CAC, according to a study presented as part of ACC’s Advancing the Cardiovascular Care of the Oncology Patient virtual course, taking place Feb. 11-12.

Researchers at Washington University in St. Louis looked at non-small cell lung cancer patients who underwent non-contrast chest CT scans for treatment planning between 2001 to 2014 to evaluate CAC. Patients were stratified into no, mild, moderate and severe CAC groups. Data on demographics, comorbidities and radiation treatment characteristics were also gathered for inclusion. The researchers then assessed the incidence of major adverse cardiovascular events, such as myocardial infarction or stroke, after initiation of radiation therapy across the CAC groups.

The study included 155 patients, which included 41 patients with no CAC, 45 patients with mild CAC, 39 patients with moderate CAC and 30 patients with severe CAC. There were three major adverse cardiovascular events in the no CAC group, seven events in the mild group, five in the moderate group and five in the severe group.

Results showed that average and max radiation dose to the heart were not associated with a major adverse cardiovascular event in the researchers’ time to event analysis. After adjusting for age and sex, the CAC group was associated with increased risk of major adverse cardiovascular events. When compared to no CAC, the mild group was associated with 11.7 times increased risk for a major adverse cardiovascular event and severe CAC had a 21.4 times increased risk. Moderate CAC showed a trend toward increased risk.

CAC burden is an important risk factor in patients with non-small cell lung cancer undergoing thoracic radiation and may be a useful indicator in cardiac risk-stratification of these patients,” said Matthew Lui, MD, an internal medicine resident at Washington University in St. Louis and the study’s lead author. “We believe further study evaluating the utility of CAC burden in determining cardiovascular risk in other cancer populations is warranted and can help validate CAC burden across different populations.”

ACC’s Advancing the Cardiovascular Care of the Oncology Patient virtual course features the latest research, best practices and case discussions on evidence-based treatment strategies with practical tips to comprehensively care for cancer patients and survivors.

Other abstracts presented at the meeting include:

  • Assessment of Cardiovascular Disease Risk Factor Control in Triple Negative Breast Cancer Patients
  • Cardiovascular Disease in Patients with Thymic Cancer
  • Effectiveness of Virtual Cardio-Oncology Zoom Clinics on Long-term Patient Safety and Positive Satisfaction in a Tertiary Care Centre During COVID Pandemics

On-demand access to sessions and additional content will be available through March 16. Also stay up to date throughout the course via social media by using the hashtags #CardioOnc and #ACCEd and following @ACCinTouch.

Clinical Topics: Cardio-Oncology, Noninvasive Imaging, Computed Tomography, Nuclear Imaging

Keywords: Stroke, Survivors, Thymus Neoplasms, Radiation Dosage, Internal Medicine, Heart Disease Risk Factors, Myocardial Infarction, Tomography, X-Ray Computed, Lung Neoplasms, Risk Factors, Triple Negative Breast Neoplasms, Tertiary Care Centers, Personal Satisfaction, Patient Safety, Pandemics, Carcinoma, Non-Small-Cell Lung, Cardiovascular Diseases, Neoplasms, Cardiotoxicity

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