TY - JOUR
T1 - Is the coronary artery calcium score associated with acute coronary events in breast cancer patients treated with radiotherapy?
AU - Roos, C.T.G.
AU - van den Bogaard, V.A.B.
AU - Greuter, M.J.W.
AU - Vliegenthart, R.
AU - Schuit, E.
AU - Langendijk, J.A.
AU - van der Schaaf, A.
AU - Crijns, A.P.G.
AU - Maduro, J.H.
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
KW - Coronary artery calcium
KW - Breast cancer
KW - Cardiac toxicity
KW - COMPUTED-TOMOGRAPHY
KW - HEART-DISEASE
KW - IRRADIATION TECHNIQUES
KW - ADJUVANT RADIOTHERAPY
KW - RADIATION-THERAPY
KW - RISK
KW - PROTON
KW - COHORT
KW - WOMEN
KW - CT
U2 - 10.1016/j.radonc.2017.10.009
DO - 10.1016/j.radonc.2017.10.009
M3 - Article
C2 - 29089148
SN - 0167-8140
VL - 126
SP - 170
EP - 176
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
T2 - 15th International Wolfsberg Meeting on Molecular Radiation Biology/Oncology
Y2 - 17 June 2017 through 19 June 2017
ER -