CT-defined coronary artery calcification (CAC) scores can help predict the occurrence of conditions such as heart attack or stroke in lung cancer patients, German researchers have reported.
"[We found] a meaningful impact of the CAC score on overall survival and [that it] was associated with the occurrence of major cardiovascular events," wrote a team led by Hans-Jonas Meyer of the University of Leipzig. The group's findings were published on 18 November in Academic Radiology.
CAC can be quantified by CT imaging and is an important predictor for cardiovascular disease, the team explained. Preliminary studies have explored the prognostic role of CT-defined CAC scores in cancer patients, but as more evidence is needed, the investigators conducted a literature review that explored the effect of CAC scores on overall survival in lung cancer patients.
"[There] are recent promising results regarding the associations between CAC and survival outcomes in oncology patients," the authors noted. "The rationale is that CAC may indicate poor cardiac status, presumably before clinical symptoms are present, and may therefore stratify patients at risk for poorer outcome … [and] in lung cancer patients, the CAC score may be particularly relevant, as most patients are heavy tobacco users and therefore at risk for cardiovascular disease."
The team included seven studies culled from MEDLINE, Google Scholar, and Scopus databases that analyzed any associations between CAC and lung cancer patients up to June 2024; the studies included 2,292 patients undergoing curative treatment. The primary endpoint of Meyers's and colleagues' research was overall survival.
The investigators found the following:
- The hazard ratio for the association between CAC score and overall survival was 1.42 (with 1 as reference) in univariable analysis and 1.56 in multivariable analysis.
- The odds ratio for the association between CAC score and major cardiovascular events was 1.97 (with 1 as reference).
The study findings suggest that a CT-defined CAC score has a "meaningful impact on overall survival and prediction of major cardiovascular events in lung cancer patients undergoing curative treatment," according to the team.
"The sole presence of CAC on staging CT should be reported as an important prognostic marker in these patients," it concluded.
The complete study can be found here.
