Coronary artery calcium in breast cancer survivors after radiation therapy

The purpose of the current study is to investigate whether breast cancer survivors after radiation therapy have a higher burden of coronary artery calcium as a potential surrogate of radiation-induced accelerated coronary artery disease. 333 patients were included. 54 patients underwent chest CT ≥ 6...

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Main Authors: Takx, Richard A. P. (Author) , Pilz, Lothar R. (Author) , Schönberg, Stefan (Author) , Henzler, Thomas (Author) , Apfaltrer, Paul (Author)
Format: Article (Journal)
Language:English
Published: 24 March 2017
In: The international journal of cardiovascular imaging
Year: 2017, Volume: 33, Issue: 9, Pages: 1425-1431
ISSN:1875-8312
DOI:10.1007/s10554-017-1119-x
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s10554-017-1119-x
Verlag, Volltext: https://doi.org/10.1007/s10554-017-1119-x
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Author Notes:Richard A.P. Takx, Rozemarijn Vliegenthart, U. Joseph Schoepf, Lothar R. Pilz, Stefan O. Schoenberg, Pamela B. Morris, Thomas Henzler, Paul Apfaltrer

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520 |a The purpose of the current study is to investigate whether breast cancer survivors after radiation therapy have a higher burden of coronary artery calcium as a potential surrogate of radiation-induced accelerated coronary artery disease. 333 patients were included. 54 patients underwent chest CT ≥ 6 months after the start of radiation therapy (radiation therapy group), while 279 patients had a CT scan either prior to or without undergoing radiation therapy (RT). Coronary artery calcium was quantified from CT by applying a threshold-based automated algorithm. Mean age at diagnosis was similar (p = 0.771) between RT (57.4 ± 13.1 years) and NoRT (58.0 ± 11.9 years). Median time between radiation therapy and CT was 2 years. The groups showed no significant differences in race, smoking history, cancer laterality, or cancer stage. 39 (72.2%) of RT patients had a coronary artery calcium score of 0, compared to 201 (72.0%) in patients without radiation therapy. Median coronary artery calcium burden for both groups was not significantly different (p = 0.982), nor when comparing patients who underwent left- versus right-sided radiation therapy (p = 0.453). When adjusting for the time between diagnosis and CT, radiation therapy patients had a significantly lower risk of a positive coronary artery calcium score. In conclusion, breast cancer survivors after radiation therapy are not more likely to show coronary artery calcium on follow-up CT imaging. Our results thus do not support radiation-induced accelerated coronary artery disease as an explanation for higher rates of heart disease in this group. 
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