Author + information
- Matthew C. Hooks,
- Prabhjot Nijjar,
- Ko-Hsuan Chen,
- Michelle Wang,
- Milkeesso Foge,
- Ryan Cullen,
- Tejaswini Maganti,
- Anne Blaes and
- Chetan Shenoy
Cancer patients are at increased risk of cardiovascular disease (CVD) after potentially cardiotoxic cancer treatment. Preexisting coronary artery disease (CAD) is an important risk factor for such CVD. Many cancer patients undergo computed tomography (CT) imaging for cancer staging prior to treatment. Coronary artery calcification (CAC) noted on these scans could be used to predict which patients are at risk for CVD after potentially cardiotoxic cancer treatment. This requires clinical reporting of the presence of CAC and action in those with it. How frequently this is currently done is unknown. The aim of this study was to determine how often CAC on cancer CT scans was clinically reported, and how often it was acted upon for the primary prevention of CVD.
Consecutive patients aged 45 years or older with cancer who received CT for cancer staging prior to treatment with anthracycline and/or trastuzumab were included. Scans were interpreted for the presence or absence of CAC. In those with CAC, electronic medical records were reviewed to determine if CAC was reported, and if there was any clinical action in response. We collected information on rates of initiation of aspirin and statin, and of cardiology evaluation for the primary prevention of CVD.
The study cohort consisted of 1,001 patients treated with anthracyclines and/or trastuzumab, with 38% men and a mean age of 62 years. The most common cancers were breast cancer (28%), lymphoma (22%) and sarcoma (12%). In 349 (35%) patients with CAC, it was clinically reported in 178 (51%) patients. Of the 349 with CAC, 56 (16%) had known CAD, 152 (44%) were on aspirin, and 159 (46%) were on a statin at the time of the CT. Prior to cancer treatment, 24 patients with CAC were referred to cardiology, though only 10 of those were for the primary prevention of CVD. Only 5 and 3 patients were newly started on aspirin and statin respectively.
CAC on cancer CT scans is clinically reported in only 51% of patients. It is rarely acted upon clinically. This incidental and readily available risk marker offers an under-recognized opportunity for action aimed at the primary prevention of CVD after potentially cardiotoxic cancer treatment.
Poster Hall, Hall F
Monday, March 18, 2019, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Clinical 5
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1331-416
- 2019 American College of Cardiology Foundation