Key result
High baseline CAC linked to ~9.5-fold higher CAD risk after radiotherapy.
Why the study?
Radiotherapy increases CAD risk via heart radiation dose metrics, while baseline coronary artery calcification also elevates CAD risk, warranting evaluation of their combined effects.
Does the presence of coronary artery calcifications and higher mean heart dose increase the risk of coronary artery disease in high-risk breast cancer patients receiving radiotherapy?
Cohort (n=3,355)
Yes
Does the presence of coronary artery calcifications and higher mean heart dose increase the risk of coronary artery disease in high-risk breast cancer patients receiving radiotherapy?
Hazard Ratio: 9.51 (95% CI 5.16–17.53)
Absolute Event Rate: 7.7% vs 1%
p-value: p=<0.01
Coronary artery calcification scoring on routine radiotherapy planning CT scans strongly predicts future coronary artery disease risk in breast cancer patients, outperforming radiation dose metrics in patients with high baseline calcification.
Agatston scoring on planning CTs may stratify CAD risk in breast radiotherapy patients; leaves open dose effects in high-calcification subgroups.
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Refsgaard et al. (2024) conducted a cohort in High-risk breast cancer (n=3,355). Coronary artery calcification (Agatston score ≥ 100) vs. Agatston score < 100 was evaluated on Coronary artery disease (HR 9.51, 95% CI 5.16-17.53, p=<0.01). Pronounced coronary artery calcification (Agatston score ≥ 100) at the time of radiotherapy increased the risk of coronary artery disease by a hazard ratio of 9.51 compared to a score < 100.
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