Introduction:
Cardiovascular disease and cancer co-exist due to shared risk factors. The utility of coronary artery calcium (CAC) scoring in this population to predict cardiovascular events is not certain.
Methods:
We studied all patients enrolled in the CLARIFY registry of no-charge CAC (Clinicaltrials.gov NCT04075162) with diagnosis of any cancer. We followed patients for major adverse cardiovascular events (myocardial infarction, stroke, heart failure, coronary revascularization or mortality).
Results:
A total of 3,432 patients with cancer were identified. Mean age was 64±9 years, 1965 (57%) were women and 2937 (86%) were white. Overall distribution of CAC scores were as follows: CAC 0 in 35%, CAC 1-99 in 31%, CAC 100-399 in 20%, and CAC ≥ 400 in 15%. CAC distribution varied by cancer type (figure A). At a median follow-up of 663 [294-1086] days, 343 patients had MACE event. Compared with CAC 0, patients with CAC ≥ 400 had increased unadjusted risk of MACE (HR 2.57 [1.93-3.41], P<0.001), which was not attenuated after adjusting for age and sex (HR 2.09 [1.50-2.90], P<0.001).
Conclusions:
In this large cohort of patients with cancer, coronary artery atherosclerotic calcifications are common, vary by cancer type, and are associated with major adverse cardiovascular events, independently of age and sex. Further research should focus on utility of routine CAC for cardiovascular risk stratification in patients with cancer.
Utility of Per Vessel Coronary Artery Calcium (CAC) Score in Symptomatic Patients Undergoing Coronary Computed Tomography in Predicting Major Adverse Cardiovascular Events: Single Center Experience and Literature Review
