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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

AIM: Validation of coronary artery calcium (CAC) scores as prognostic factors of acute coronary events (ACE) development in breast cancer patients are demanded. We investigated prognostic impact of CAC on ACE development with cardiac exposure to radiation. METHODS: We evaluated breast cancer patient...

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Autores principales: Kim, Kangpyo, Chung, Seung Yeun, Oh, Caleb, Cho, Iksung, Kim, Kyung Hwan, Byun, Hwa Kyung, Yoon, Hong In, Oh, Jaewon, Chang, Jee Suk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307671/
https://www.ncbi.nlm.nih.gov/pubmed/35870419
http://dx.doi.org/10.1016/j.breast.2022.07.003
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author Kim, Kangpyo
Chung, Seung Yeun
Oh, Caleb
Cho, Iksung
Kim, Kyung Hwan
Byun, Hwa Kyung
Yoon, Hong In
Oh, Jaewon
Chang, Jee Suk
author_facet Kim, Kangpyo
Chung, Seung Yeun
Oh, Caleb
Cho, Iksung
Kim, Kyung Hwan
Byun, Hwa Kyung
Yoon, Hong In
Oh, Jaewon
Chang, Jee Suk
author_sort Kim, Kangpyo
collection PubMed
description AIM: Validation of coronary artery calcium (CAC) scores as prognostic factors of acute coronary events (ACE) development in breast cancer patients are demanded. We investigated prognostic impact of CAC on ACE development with cardiac exposure to radiation. METHODS: We evaluated breast cancer patients with (n = 511) or without (n = 600) adjuvant radiotherapy (RT) between 2005 and 2013. CAC Agatston scores were analyzed using a deep-learning-based algorithm. Individual mean heart dose (MHD) was calculated, and no RT was categorized as 0 Gy. The primary endpoint was the development of ACE following breast surgery. RESULTS: In the RT and no-RT cohorts, 11.2% and 3.7% exhibited CAC >0, respectively. Over a 9.3-year follow-up period, the 10-year ACE rate was 0.7%. In the multivariate analysis, the CAC score was a significant risk factor for ACE (CAC >0 vs CAC = 0, 10-year 6.2% vs 0.2%, P < 0.001). In the subgroup with CAC >0, the 10-year ACE rates were 0%, 3.7%, and 13.7% for patients receiving mean heart doses of 0 Gy, 0–3 Gy, and >3 Gy, respectively (P = 0.133). Although CAC score was not predictive for non-ACE heart disease risk (P > 0.05), the 10-year non-ACE heart disease rates were 1.7%, 5.7%, and 7.1% for patients with CAC = 0 receiving MHD of 0 Gy, 0–3 Gy, and >3 Gy, respectively (P < 0.001). CONCLUSIONS: The CAC score was a significant predictor of ACE in patients with breast cancer. Although further studies are required, CAC score screening on simulation CT in patients undergoing breast RT can help identify those with high risk for ACE on a per-patient basis.
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spelling pubmed-93076712022-07-24 Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy Kim, Kangpyo Chung, Seung Yeun Oh, Caleb Cho, Iksung Kim, Kyung Hwan Byun, Hwa Kyung Yoon, Hong In Oh, Jaewon Chang, Jee Suk Breast Original Article AIM: Validation of coronary artery calcium (CAC) scores as prognostic factors of acute coronary events (ACE) development in breast cancer patients are demanded. We investigated prognostic impact of CAC on ACE development with cardiac exposure to radiation. METHODS: We evaluated breast cancer patients with (n = 511) or without (n = 600) adjuvant radiotherapy (RT) between 2005 and 2013. CAC Agatston scores were analyzed using a deep-learning-based algorithm. Individual mean heart dose (MHD) was calculated, and no RT was categorized as 0 Gy. The primary endpoint was the development of ACE following breast surgery. RESULTS: In the RT and no-RT cohorts, 11.2% and 3.7% exhibited CAC >0, respectively. Over a 9.3-year follow-up period, the 10-year ACE rate was 0.7%. In the multivariate analysis, the CAC score was a significant risk factor for ACE (CAC >0 vs CAC = 0, 10-year 6.2% vs 0.2%, P < 0.001). In the subgroup with CAC >0, the 10-year ACE rates were 0%, 3.7%, and 13.7% for patients receiving mean heart doses of 0 Gy, 0–3 Gy, and >3 Gy, respectively (P = 0.133). Although CAC score was not predictive for non-ACE heart disease risk (P > 0.05), the 10-year non-ACE heart disease rates were 1.7%, 5.7%, and 7.1% for patients with CAC = 0 receiving MHD of 0 Gy, 0–3 Gy, and >3 Gy, respectively (P < 0.001). CONCLUSIONS: The CAC score was a significant predictor of ACE in patients with breast cancer. Although further studies are required, CAC score screening on simulation CT in patients undergoing breast RT can help identify those with high risk for ACE on a per-patient basis. Elsevier 2022-07-11 /pmc/articles/PMC9307671/ /pubmed/35870419 http://dx.doi.org/10.1016/j.breast.2022.07.003 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Article
Kim, Kangpyo
Chung, Seung Yeun
Oh, Caleb
Cho, Iksung
Kim, Kyung Hwan
Byun, Hwa Kyung
Yoon, Hong In
Oh, Jaewon
Chang, Jee Suk
Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title_full Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title_fullStr Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title_full_unstemmed Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title_short Automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
title_sort automated coronary artery calcium scoring in patients with breast cancer to assess the risk of heart disease following adjuvant radiation therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307671/
https://www.ncbi.nlm.nih.gov/pubmed/35870419
http://dx.doi.org/10.1016/j.breast.2022.07.003
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