A coronary artery calcium (CAC) score >0 was a significant predictor of 10-year acute coronary events compared to a CAC score of 0 (6.2% vs 0.2%, P<0.001) in patients with breast cancer.
Cohort (n=1,111)
Does the presence of coronary artery calcium (CAC >0) predict the development of acute coronary events in breast cancer patients with or without adjuvant radiotherapy?
Automated CAC scoring on simulation CT is a significant predictor of acute coronary events in breast cancer patients, which may help identify those at high risk following adjuvant radiotherapy.
Absolute Event Rate: 6.2% vs 0.2%
p-value: p=<0.001
AIM: Validation of coronary artery calcium (CAC) scores as prognostic factors of acute coronary events (ACE) development in breast cancer patients are demanded. We investigated prognostic impact of CAC on ACE development with cardiac exposure to radiation. METHODS: We evaluated breast cancer patients with (n = 511) or without (n = 600) adjuvant radiotherapy (RT) between 2005 and 2013. CAC Agatston scores were analyzed using a deep-learning-based algorithm. Individual mean heart dose (MHD) was calculated, and no RT was categorized as 0 Gy. The primary endpoint was the development of ACE following breast surgery. RESULTS: In the RT and no-RT cohorts, 11.2% and 3.7% exhibited CAC >0, respectively. Over a 9.3-year follow-up period, the 10-year ACE rate was 0.7%. In the multivariate analysis, the CAC score was a significant risk factor for ACE (CAC >0 vs CAC = 0, 10-year 6.2% vs 0.2%, P 0, the 10-year ACE rates were 0%, 3.7%, and 13.7% for patients receiving mean heart doses of 0 Gy, 0-3 Gy, and >3 Gy, respectively (P = 0.133). Although CAC score was not predictive for non-ACE heart disease risk (P > 0.05), the 10-year non-ACE heart disease rates were 1.7%, 5.7%, and 7.1% for patients with CAC = 0 receiving MHD of 0 Gy, 0-3 Gy, and >3 Gy, respectively (P < 0.001). CONCLUSIONS: The CAC score was a significant predictor of ACE in patients with breast cancer. Although further studies are required, CAC score screening on simulation CT in patients undergoing breast RT can help identify those with high risk for ACE on a per-patient basis.
Kim et al. (Mon,) conducted a cohort in Breast cancer (n=1,111). Coronary artery calcium (CAC) score >0 vs. CAC score = 0 was evaluated on Development of acute coronary events (ACE) following breast surgery (p=<0.001). A coronary artery calcium (CAC) score >0 was a significant predictor of 10-year acute coronary events compared to a CAC score of 0 (6.2% vs 0.2%, P<0.001) in patients with breast cancer.