Comparison of Framingham risk score and chest-CT identified coronary artery calcification in breast cancer patients to predict cardiovascular events

In breast cancer patients, coincidental detection of CAC at chest CT may be important in determining cardiovascular (CV) outcomes and facilitate CV disease primary prevention strategies. 408 consecutive breast cancer patients referred to cardiac oncology clinic were included in the study. 256 patien...

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Bibliographic Details
Published in:International journal of cardiology 2019-08, Vol.289, p.138-143
Main Authors: Phillips, William J., Johnson, Christopher, Law, Angeline, Turek, Michele, Small, Alex R., Dent, Susan, Ruddy, Terrence D., Beanlands, Rob S., Chow, Benjamin J.W., Small, Gary R.
Format: Article
Language:English
Subjects:
Aged
Breast Neoplasms - complications
Breast Neoplasms - diagnosis
Cardiac oncology
Cardiovascular events
Coronary Angiography
Coronary Artery Disease - diagnosis
Coronary Artery Disease - epidemiology
Coronary Artery Disease - etiology
Coronary calcification
Coronary Vessels - diagnostic imaging
Female
Follow-Up Studies
Humans
Incidence
Middle Aged
Predictive Value of Tests
Prevalence
Radiography, Thoracic - methods
Retrospective Studies
Risk Assessment - methods
Risk Factors
Time Factors
Tomography, X-Ray Computed - methods
Vascular Calcification - diagnosis
Vascular Calcification - epidemiology
Vascular Calcification - etiology
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Summary:In breast cancer patients, coincidental detection of CAC at chest CT may be important in determining cardiovascular (CV) outcomes and facilitate CV disease primary prevention strategies. 408 consecutive breast cancer patients referred to cardiac oncology clinic were included in the study. 256 patients without a prior history of coronary artery disease had undergone a chest CT. CT images were reviewed to detect CAC. Framingham risk score (FRS) was calculated and patient electronic medical records were interrogated to document the incidence of a composite clinical end point of all-cause mortality and cardiac events (coronary revascularization, heart failure hospitalization and de novo atrial fibrillation). Prevalence of statin prescribing was also collected. Patients were followed for a median of 6.5 years. 112 clinical events occurred. Clinical follow up was 98%. CAC was found in 26% of patients. On multivariable analysis, CAC and advance cancer stage, but not FRS predicted the composite clinical end point (OR for CAC 2.59, p 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2019.01.056