Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy

Kim, Kangpyo; Chung, Sung Pil; Oh, Caleb; Cho, Iksung; Kim, Kyung Hwan; Byun, Hwa Kyung; Yoon, Hong In; Oh, Jaewon; Chang, Jee Suk

doi:10.1016/j.breast.2022.07.003

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…Coronary atherosclerotic plaques can be classified as calcified, non-calcified, or mixed [11]. Previous studies, including ours, showed an association between cardiac exposure and increased coronary artery calcium score [6,17,25]. Although the coronary artery calcium score serves as a surrogate for total coronary atherosclerotic burden, and correlates with risk of mortality, [26] it does not consider non-calcified plaque, which may be more relevant for risk assessment [27,28].…”

Section: Discussionmentioning

confidence: 92%

Early development of atherosclerotic plaques in the coronary arteries after radiotherapy for breast cancer (BACCARAT study)

Honaryar,

Allodji,

Jimenez

et al. 2024

Archives of Cardiovascular Diseases

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Section: Discussionmentioning

confidence: 92%

Early development of atherosclerotic plaques in the coronary arteries after radiotherapy for breast cancer (BACCARAT study)

Honaryar,

Allodji,

Jimenez

et al. 2024

Archives of Cardiovascular Diseases

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“…Both cardiac exposure and pre-treatment CAC, in BC patients treated with RT, have been shown to be associated with the risk of coronary artery disease several years after RT [ 6 , 7 , 9 , 10 , 11 ]. At an earlier stage of the coronary artery disease, assessment of CAC progression is regarded as a dynamic measurement that might provide insight into ongoing current disease activity and more efficiently predicts future cardiac events rather than static traditional clinical parameters and baseline CAC [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Baseline measures of coronary artery calcification (CAC), as quantified by cardiac computed tomography (CT), have been shown to predict future cardiovascular events, in particular CAD, in multiple populations [ 8 ]. In the population of BC patients treated with RT, several studies found that pre-treatment CAC was associated with acute coronary event and CAD risk [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Early Coronary Artery Calcification Progression over Two Years in Breast Cancer Patients Treated with Radiation Therapy: Association with Cardiac Exposure (BACCARAT Study)

Honaryar

Allodji

Ferrières

et al. 2022

Cancers

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Background: Radiotherapy (RT) for breast cancer (BC) can induce coronary artery disease many years after RT. At an earlier stage, during the first two years after RT, we aimed to evaluate the occurrence of increased coronary artery calcium (CAC) and its association with cardiac exposure. Methods: This prospective study included 101 BC patients treated with RT without chemotherapy. Based on CAC CT scans performed before and two years after RT, the event ‘CAC progression’ was defined by an increase in overall CAC score (CAC RT+ two years—CAC before RT > 0). Dosimetry was evaluated for whole heart, left ventricle (LV), and coronary arteries. Multivariable logistic regression models were used to assess association with doses. Results: Two years after RT, 28 patients presented the event ‘CAC progression’, explained in 93% of cases by a higher CAC score in the left anterior descending coronary (LAD). A dose–response relationship was observed with LV exposure (for Dmean LV: OR = 1.15, p = 0.04). LAD exposure marginally explained increased CAC in the LAD (for D2 LV: OR =1.03, p = 0.07). Conclusion: The risk of early CAC progression may be associated with LV exposure. This progression might primarily be a consequence of CAC increase in the LAD and its exposure.

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“…Screening for CAD may consist of physical or pharmacological stress tests, CT scan with assessment of the calcium score, coronary CT, or even coronary angiography ( 104 – 106 ). Of these, the calcium score and coronary CT have been used in many studies ( 105 , 106 ). The choice should be made according to the availability of each test and according to the needs of the patient.…”

Section: Management Of Cancer Patients Treated With Chest Radiotherapymentioning

confidence: 99%

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals

Bisceglia,

Canale,

Silvestris

et al. 2023

Front. Cardiovasc. Med.

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In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The ultimate goal is a personalized care of CS, achievable only through a multidisciplinary-guided survivorship care plan, one that replaces the fragmented management of current healthcare systems. Collaboration between oncologists and cardiologists is the pillar of a framework in which primary care providers and other specialists must be engaged and in which familial, social and environmental factors are also taken into account.

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Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy

Cited by 13 publications

References 33 publications

Early development of atherosclerotic plaques in the coronary arteries after radiotherapy for breast cancer (BACCARAT study)

Early development of atherosclerotic plaques in the coronary arteries after radiotherapy for breast cancer (BACCARAT study)

Early Coronary Artery Calcification Progression over Two Years in Breast Cancer Patients Treated with Radiation Therapy: Association with Cardiac Exposure (BACCARAT Study)

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals

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