Association between Radiotherapy and Anatomic Severity of Coronary Artery Disease: A Propensity Score Matching Comparison Among Adult-Onset Thoracic Cancer Survivors

Abstract

Objective: To investigate the association between radiotherapy and anatomic severity of coronary artery disease (CAD) using the SYNTAX scores (SXscores) of coronary angiograms in adult-onset thoracic cancer survivors. Methods: A total of 152 patients who previously had thoracic cancer and underwent coronary angiography between 2010 and 2016 were examined. Propensity score matching (PSM) was used to identify 27 well-matched pairs of patients. Characteristics and coronary angiograms were collected from each patient. Coronary artery abnormalities were assessed using SXscores of coronary angiograms. Results: Among the 152 patients, the SXscores and percentage of high SXscores were higher in the radiotherapy group than in the non-radiotherapy group; however, the latter was not significantly different (p = 0.0266 and p = 0.064, respectively). After PSM, the SXscores and percentage of high SXscores were significantly higher in the radiotherapy group than in the non-radiotherapy group (22 [interquartile range (IQR) 10.00–30.00] vs. 15.00 [IQR 4.00–26.00], p = 0.0459), (70.07 vs. 44.44%, p = 0.027), respectively. After adjusting for related risk factors and chemotherapy, the OR of radiotherapy for a high SXscore was 3.674 (95% CI 1.094–12.343) by logistic regression analysis. Conclusion: Thoracic cancer survivors who underwent radiotherapy have higher SXscores and are at a higher risk of developing anatomically severe CAD, independent of chemotherapy.

Ablação por Cateter sem Uso de Raios X para Tratamento de Fibrilação Atrial e Arritmias Atriais

“…27 Previous studies have shown the effect of radiation on heart diseases. 20,[28][29][30] In the present study, both the SXscore and the SXhigh percentage were greater in the radiotherapy group in relation to the non-radiotherapy group. Nevertheless, no significant differences were observed between the two groups.…”

“…Higher SXscores, indicative of morecomplex diseases, are hypothesized to represent a greater therapeutic challenge and to pose potentially worse cardiac prognoses. 16,17,[19][20][21] Recent studies used SXscore to quantify the severity of CAD among cancer patients, which looked mostly at the effect of radiotherapy on CAD. 20,21 In the present study, we used SXscore to evaluate the complexity and severity of CAD among lung cancer patients to investigate the relationship between chemotherapy and CAD.…”

“…16,17,[19][20][21] Recent studies used SXscore to quantify the severity of CAD among cancer patients, which looked mostly at the effect of radiotherapy on CAD. 20,21 In the present study, we used SXscore to evaluate the complexity and severity of CAD among lung cancer patients to investigate the relationship between chemotherapy and CAD. We also observed the effect of radiotherapy and other risk factors on anatomical severity of coronary arteries among those patients.…”

Associação entre a Gravidade da Doença Arterial Coronariana e Câncer de Pulmão: Um Estudo Piloto Transversal

“…[2][3][4][5] No momento, oncologistas e cardiologistas estão mais focados em doenças cardíacas relacionadas à terapia anticâncer entre os sobreviventes de câncer. 6,7 Alguns estudos demonstram que há uma relação direta de interação entre doenças cardíacas e câncer. 8 A doença arterial coronariana (DAC) e o câncer compartilham fatores de risco em comum, além de mecanismos fisiopatológicos.…”

Avaliação da Gravidade da Doença Arterial Coronariana em Pacientes Tratados com Quimioterapia: A Necessidade Adicional da Cardio-Oncologia

“…3,4 The risk and anatomic severity of CAD related to radiotherapy treatment has been described. 5,6 In a study of 152 thoracic cancer survivors who underwent radiotherapy, the investigators observed that the study patients had higher SYNTAX scores and were at a higher risk of developing anatomically severe CAD, independent of chemotherapy. 6 While although CAD is known to be present in patients being treated with chemotherapy, independent of radiotherapy, the association between anatomic severity of CAD and chemotherapy is less well known.…”