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Multicenter Study
. 2015 Nov 9;4(11):e002533.
doi: 10.1161/JAHA.115.002533.

Cancer and Its Association With the Development of Coronary Artery Calcification: An Assessment From the Multi-Ethnic Study of Atherosclerosis

Matthew C Whitlock  1 , Joseph Yeboah  1 , Gregory L Burke  2 , Haiying Chen  3 , Heidi D Klepin  4 , W Gregory Hundley  5
Affiliations
Multicenter Study

Cancer and Its Association With the Development of Coronary Artery Calcification: An Assessment From the Multi-Ethnic Study of Atherosclerosis

Matthew C Whitlock et al. J Am Heart Assoc. .

Abstract

Background: Although cancer and its corresponding therapies are associated with increased ischemic heart disease, the temporal relationship between cancer and the development of coronary artery calcium (CAC), a marker of subclinical atherosclerosis, is unknown.

Methods and results: Among 3122 men and women free of cardiovascular disease and cancer in the Multi-Ethnic Study of Atherosclerosis trial, CAC scoring was performed at baseline (2000-2002) and at follow-up (2010-2012). Over this 10-year period, 85 men (age 63.6±8.3 years) and 50 women (age 62.1±9.8 years) were diagnosed with cancer (predominantly breast, lung, or uterine [52%] in women and prostate or colorectal [78%] in men). The other 2987 subjects (age 59.6±9.2 years for men, 59.7±9.4 years for women) remained cancer free. The incidence of new CAC (baseline Agatston score of zero converting to detectable CAC) was modeled with relative risk regression and compared for cancer versus no cancer. Increase in pre-existing CAC was compared in these groups using linear regression of log transformed CAC. The incidence of CAC was independently associated with cancer history (relative risk 1.32 [P=0.04] and 1.29 [P=0.01] for women and men, respectively). In participants with CAC at baseline, a clear difference of CAC progression was not observed between cancer and noncancer participants (P=0.6 for women, P=0.2 for men).

Conclusions: A diagnosis of cancer is associated with the development of CAC even after accounting for atherosclerotic risk factors. However, in individuals with pre-existing CAC, it is not clear whether the presence of cancer accelerates CAC over time.

Keywords: cancer; cardiotoxicity; coronary artery calcium; subclinical atherosclerosis risk factor.

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Figures

Figure 1
Figure 1
Flow diagram of MESA cohort who underwent serial coronary artery calcification assessments divided into cancer and no‐cancer subgroups. CT indicates computed tomography; MESA, Multi‐Ethnic Study of Atherosclerosis.
Figure 2
Figure 2
Unadjusted and adjusted relative risk of the incidence (defined as undetectable coronary artery calcium [CAC] at baseline transitioning to presence of CAC at follow‐up) of coronary artery calcification over 10 years in those with cancer versus those without, stratified by sex. Both women and men with cancer experience significantly higher incidence of CAC as compared to participants without a cancer history, even after adjusting for known cardiovascular risk factors (Model 1: age and race/ethnicity. Model 2: model 1 and lipid medication, total cholesterol, high‐density lipoprotein, on hypertension medication, systolic blood pressure, current or former smoker, and history of diabetes).
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References

    1. Hooning MJ, Botma A, Aleman BMP, Baaijens MHA, Bartelink H, Klijn JGM, Taylor CW, van Leeuwen FE. Long‐term risk of cardiovascular disease in 10‐year survivors of breast cancer. J Natl Cancer Inst. 2007;99:365–375. - PubMed
    1. van den Belt‐Dusebout AW, Nuver J, de Wit R, Gietema JA, ten Bokkel Huinink WW, Rodrigus PTR, Schimmel EC, Aleman BMP, van Leeuwen FE. Long‐term risk of cardiovascular disease in 5‐year survivors of testicular cancer. J Clin Oncol. 2006;24:467–475. - PubMed
    1. Aleman BMP, van den Belt‐Dusebout AW, Bruin MLD, van ‘t Veer MB, Baaijens MHA, de Boer JP, Hart AAM, Klokman WJ, Kuenen MA, Ouwens GM, Bartelink H, van Leeuwen FE. Late cardiotoxicity after treatment for Hodgkin lymphoma. Blood. 2007;109:1878–1886. - PubMed
    1. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. Circulation. 2007;115:402–426. - PubMed
    1. Rademaker J, Schöder H, Ariaratnam NS, Strauss HW, Yahalom J, Steingart R, Oeffinger KC. Coronary artery disease after radiation therapy for Hodgkin's lymphoma: coronary CT angiography findings and calcium scores in nine asymptomatic patients. Am J Roentgenol. 2008;191:32–37. - PubMed

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