Key result
Exposure to low-dose ionizing radiation from cardiac procedures after acute myocardial infarction increased the risk of incident cancer by 3% for every 10 mSv of radiation (HR 1.003 per mSv).
Why the study?
Does exposure to low-dose ionizing radiation from cardiac imaging and therapeutic procedures increase the risk of incident cancer in patients after acute myocardial infarction?
Cohort (n=82,861)
Yes
Does exposure to low-dose ionizing radiation from cardiac imaging and therapeutic procedures increase the risk of incident cancer in patients after acute myocardial infarction?
Exposure to low-dose ionizing radiation from cardiac imaging and therapeutic procedures after acute myocardial infarction is associated with a dose-dependent increased risk of incident cancer.
May support radiation minimization post-MI; leaves open causality and need for prospective confirmation.
BACKGROUND: Patients exposed to low-dose ionizing radiation from cardiac imaging and therapeutic procedures after acute myocardial infarction may be at increased risk of cancer. METHODS: Using an administrative database, we selected a cohort of patients who had an acute myocardial infarction between April 1996 and March 2006 and no history of cancer. We documented all cardiac imaging and therapeutic procedures involving low-dose ionizing radiation. The primary outcome was risk of cancer. Statistical analyses were performed using a time-dependent Cox model adjusted for age, sex and exposure to low-dose ionizing radiation from noncardiac imaging to account for work-up of cancer. RESULTS: Of the 82,861 patients included in the cohort, 77% underwent at least one cardiac imaging or therapeutic procedure involving low-dose ionizing radiation in the first year after acute myocardial infarction. The cumulative exposure to radiation from cardiac procedures was 5.3 milliSieverts (mSv) per patient-year, of which 84% occurred during the first year after acute myocardial infarction. A total of 12 020 incident cancers were diagnosed during the follow-up period. There was a dose-dependent relation between exposure to radiation from cardiac procedures and subsequent risk of cancer. For every 10 mSv of low-dose ionizing radiation, there was a 3% increase in the risk of age- and sex-adjusted cancer over a mean follow-up period of five years (hazard ratio 1.003 per milliSievert, 95% confidence interval 1.002-1.004). INTERPRETATION: Exposure to low-dose ionizing radiation from cardiac imaging and therapeutic procedures after acute myocardial infarction is associated with an increased risk of cancer.
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Eisenberg et al. (2011) conducted a cohort in Acute myocardial infarction (n=82,861). Low-dose ionizing radiation from cardiac imaging and therapeutic procedures vs. No exposure to low-dose ionizing radiation from cardiac procedures was evaluated on Incident cancer (HR 1.003 per mSv, 95% CI 1.002-1.004). Exposure to low-dose ionizing radiation from cardiac procedures after acute myocardial infarction increased the risk of incident cancer by 3% for every 10 mSv of radiation (HR 1.003 per mSv).
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