Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy?

Catharina T G Roos; Veerle A B van den Bogaard; Marcel J W Greuter; Rozemarijn Vliegenthart; Ewoud Schuit; Johannes A. Langendijk; Arjen Van Der Schaaf; Anne P G Crijns; John H. Maduro

doi:10.1016/j.radonc.2017.10.009

Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy?

Catharina T G Roos, Veerle A B van den Bogaard, Marcel J W Greuter, Rozemarijn Vliegenthart, Ewoud Schuit, Johannes A. Langendijk, Arjen Van Der Schaaf, Anne P G Crijns, John H. Maduro

Julius Center, dept. Epidemiology & Health Economics

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND PURPOSE: The main objective of this study was to test whether pre-treatment coronary artery calcium (CAC) was associated with the cumulative incidence of acute coronary events (ACE) among breast cancer (BC) patients treated with postoperative radiotherapy (RT).

MATERIAL AND METHODS: The study population consisted of 939 consecutive female BC patients treated with RT. The association between CAC and ACE was tested using Cox-proportional hazard models. Known risk factors for ACE and the mean heart dose (MHD), collected from three-dimensional computed tomography planning data, were tested for confounding.

RESULTS: CAC scores varied from 0 to 2,859 (mean 27.3). The 9-year cumulative incidence of ACE was 3.2%, this was significantly associated with the pre-treatment CAC score. After correction for confounders, age, history of ischemic heart disease, diabetes, Body Mass Index ≥30, MHD, hypercholesterolemia and hypertension, the hazard ratio for ACE for the low and the combined intermediate and high CAC score category were 1.42 (95%CI: 0.49-4.17; p = 0.519) and 4.95 (95%CI: 1.69-14.53; p = 0.004) respectively, compared to the CAC zero category.

CONCLUSIONS: High pre-treatment CAC is associated with ACE in BC patients treated with postoperative RT, even after correction for confounding factors such as MHD.

Original language	English
Pages (from-to)	170-176
Number of pages	7
Journal	Radiotherapy & Oncology
Volume	126
Issue number	1
DOIs	https://doi.org/10.1016/j.radonc.2017.10.009
Publication status	Published - Jan 2018

Keywords

Breast cancer
Cardiac toxicity
Coronary artery calcium

Access to Document

10.1016/j.radonc.2017.10.009

Cite this

Roos, C. T. G., van den Bogaard, V. A. B., Greuter, M. J. W., Vliegenthart, R., Schuit, E., Langendijk, J. A., Van Der Schaaf, A., Crijns, A. P. G., & Maduro, J. H. (2018). Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy? Radiotherapy & Oncology, 126(1), 170-176. https://doi.org/10.1016/j.radonc.2017.10.009

@article{6b74d87395424a2bad2b4137b1a9616b,

title = "Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy?",

abstract = "BACKGROUND AND PURPOSE: The main objective of this study was to test whether pre-treatment coronary artery calcium (CAC) was associated with the cumulative incidence of acute coronary events (ACE) among breast cancer (BC) patients treated with postoperative radiotherapy (RT).MATERIAL AND METHODS: The study population consisted of 939 consecutive female BC patients treated with RT. The association between CAC and ACE was tested using Cox-proportional hazard models. Known risk factors for ACE and the mean heart dose (MHD), collected from three-dimensional computed tomography planning data, were tested for confounding.RESULTS: CAC scores varied from 0 to 2,859 (mean 27.3). The 9-year cumulative incidence of ACE was 3.2%, this was significantly associated with the pre-treatment CAC score. After correction for confounders, age, history of ischemic heart disease, diabetes, Body Mass Index ≥30, MHD, hypercholesterolemia and hypertension, the hazard ratio for ACE for the low and the combined intermediate and high CAC score category were 1.42 (95%CI: 0.49-4.17; p = 0.519) and 4.95 (95%CI: 1.69-14.53; p = 0.004) respectively, compared to the CAC zero category.CONCLUSIONS: High pre-treatment CAC is associated with ACE in BC patients treated with postoperative RT, even after correction for confounding factors such as MHD.",

keywords = "Breast cancer, Cardiac toxicity, Coronary artery calcium",

author = "Roos, {Catharina T G} and {van den Bogaard}, {Veerle A B} and Greuter, {Marcel J W} and Rozemarijn Vliegenthart and Ewoud Schuit and Langendijk, {Johannes A.} and {Van Der Schaaf}, Arjen and Crijns, {Anne P G} and Maduro, {John H.}",

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier B.V.",

year = "2018",

month = jan,

doi = "10.1016/j.radonc.2017.10.009",

language = "English",

volume = "126",

pages = "170--176",

journal = "Radiotherapy & Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",