Coronary artery calcium on lung cancer radiation planning CT aids cardiovascular risk assessment.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardio-oncology Pub Date : 2024-11-12 DOI:10.1186/s40959-024-00283-5

Matthew Lui, Noah Kim, Raja Zaghlol, Pouya Joolharzadeh, Elena Deych, Clifford Robinson, Shahed Badiyan, Pamela K Woodard, Joshua D Mitchell

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Abstract

Background: Patients with non-small cell lung cancer (NSCLC) undergoing thoracic radiation are at high cardiovascular risk. Semiquantitative assessment of coronary artery calcification (CAC) on baseline planning non-gated chest computed tomography (CT) scans may help further risk stratify patients.

Objectives: This study aimed to characterize the association between CAC and major adverse cardiovascular events (MACE; myocardial infarction or stroke) and assess the utility of semiquantitative assessment of CAC.

Methods: Patients with NSCLC with non-contrast planning chest CT scans were evaluated for CAC. Planning scans were visually graded using the CAC-DRS method, stratifying patients into no, mild, moderate, and severe CAC groups. Demographics, comorbidities, and radiation treatment characteristics were gathered, and CAC groups were assessed for the incidence of MACE after initiation of radiation therapy.

Results: Out of 137 patients, 39 patients had no CAC, and 98 patients had any CAC (38 with mild CAC, 34 with moderate CAC, and 26 with severe CAC). There was 1 MACE event in the no CAC group and 11 in patients with any CAC. The presence of CAC was associated with increased MACE compared to no CAC (p = 0.034). Semiquantitative CAC analysis correlated with formal CAC scoring.

Conclusion: There is a significantly lower incidence of MACE in patients with no CAC on planning CT compared to patients with higher burdens of CAC. CAC burden is an important risk factor for adverse cardiovascular events in patients with NSCLC undergoing thoracic radiation. Semiquantitative CAC scoring may be a useful proxy when formal CAC scoring is unavailable.

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肺癌放射规划 CT 上的冠状动脉钙化有助于心血管风险评估。

背景：接受胸部放射治疗的非小细胞肺癌（NSCLC）患者具有较高的心血管风险。在基线计划非门控胸部计算机断层扫描（CT）上对冠状动脉钙化（CAC）进行半定量评估有助于进一步对患者进行风险分层：本研究旨在描述冠状动脉钙化与主要不良心血管事件（MACE；心肌梗死或中风）之间的关系，并评估对冠状动脉钙化进行半定量评估的效用：方法：对接受非对比规划胸部 CT 扫描的 NSCLC 患者进行 CAC 评估。使用 CAC-DRS 方法对规划扫描进行视觉分级，将患者分为无、轻度、中度和重度 CAC 组。收集人口统计学资料、合并症和放疗特征，并评估CAC组在放疗开始后MACE的发生率：在137名患者中，39名患者无CAC，98名患者有任何CAC（38名轻度CAC，34名中度CAC，26名重度CAC）。无CAC组有1例MACE事件，有任何CAC的患者有11例MACE事件。与无CAC相比，CAC的存在与MACE的增加有关（p = 0.034）。半定量CAC分析与正式CAC评分相关：结论：与CAC负担较重的患者相比，规划CT时无CAC的患者MACE发生率明显较低。CAC负荷是接受胸部放射治疗的NSCLC患者发生不良心血管事件的重要风险因素。在没有正式的 CAC 评分时，半定量 CAC 评分可能是一个有用的替代指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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