Coronary Artery Calsification on Chest CT Scan as Coronary Heart Disease Predictor in Lung Cancer Patients
DOI:
https://doi.org/10.36497/jri.v41i2.173Keywords:
coronary artery calcification, lung cancer, coronary heart disease, smokerAbstract
Background: Lung cancer is widely known has strong association with cardiovascular diseases, including coronary heart disease. Smoking as the main risk factor for lung cancer and coronary artery disease is strongly hypothesized as reason behind this association. Our study aimed to predict ability of coronary artery calcification based on chest CT in prevalence of coronary heart disease in patients with lung cancer. Method: This study had cross-sectional design with consecutive sampling method. Subjects in this study were adults (>18 years old) with lung cancer based on histopathological examination. Result: Forty subjects with lung cancer who undergone chest CT was selected as samples in this study. After calculated with other factors, patients with lung cancer who also had coronary artery calcification lesions in Chest CT had 73 times higher risk to develop coronary heart disease (OR=72.63%;95% CI=3.81-1386.21;P=0.004). In addition, lung cancer subjects who are current and ex-smoker had 46 times higher risk to develop coronary heart disease (OR=45.75;95% Cl=1.14-1987.62;P=0.043). Based on those findings, coronary artery calcification has 86.7% sensitivity, 80.0% specificity, 72.2% PPV and 90.9% NPV for predicting coronary heart disease in lung cancer patients. Conclusion: Coronary artery calcification based on chest CT can be utilized as coronary heart disease predictor in lung cancer patients, especially who are current and ex-smoker. Extensive studies, is needed for strengthen this finding in near future.Downloads
References
Yuan M, Li QG. Lung cancer and risk of cardiovascular disease: a meta-analysis of cohort studies. J Cardiothorac Vasc Anesth. 2018;32(1):e25-e27.
Zoller H, Ji J, Sundquist J, Sundquist K. Risk of coronary heart disease in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer. 2012;48(1):121-128.
Armenian SH, Xu, L, Ky B, Sun C, Farol LT, Pal SK, et al. Cardiovascular disease among survivors of adult-onset cancer: a community-based restrospective cohort study. J Clin Oncol;34(10):1122-30.
van Herk Sukel MPP, Shantakumar S, Penning-van Beest FJA, Kamphuisen PW, Majoor CJ, Overbeek LIH, et al. Pulmonary embolism, myocardial infarction, and ischemic stroke in lung cancer patients: results from a longitudinal study. Lung;191(5):501-9.
Yoon DW, Shin DW, Cho JH, Yang JH, Jeong SM, Han K, et al. Increased risk of coronary heart disease and stroke in lung cancer survivors: a Korean nationwide study of 20.458 patients. Lung Cancer. 2019;136: 5-21.
Hedley AJ, McGhee SM, Repace JL, Wong LC, Yu MYS, Wong T, et al. Risks for heart disease and lung cancer from passive smoking by workers in the catering industry. Toxicological Sciences. 2006;90(2):539-48.
Goldkorn T, Filosto S, Chung S. Lung injury and lung cancer caused by Cigarette Smoke-Induced Oxidative Stress: Molecular Mechanisms and Therapeutic Opportunities Involving the Ceramide-Generating Machinery and Epidermal Growth Factor Receptor. Antioxid Redox Signla. 2014;21(15):2149-74.
Walser T, Cui X, Yanagawa J, Lee JM, Heinrich E, Lee G, et al. Smoking and lung cancer: the role of inflammation. Proc Am Thorac Soc. 2008;5(8):811-5.
Kadara H, Scheet P, Wistuba II, Spira AE. Early events in the molecular pathogenesis of lung cancer. Cancer Prev Res; 9(7): 518-26.
Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. Cell Physiol. 2019;234(10):1-12.
Stallones RA. The association between tobacco smoking and coronary heart disease. Int J Epidemiol. 2015;44(3):735-43.
Nakamura K, Barzi F, Huxley R, Lam TH, Suh I, Woo J, et al. Asia Pacific Cohort Studies Collaboration. does cigarette smoking exacerbate the effect of total cholesterol and high-density lipoprotein cholesterol on the risk of cardiovascular diseases? Heart. 2009;95:909–16.
Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol. 2014;34(3):509-15.
Ravenel JG, Nance JW. Coronary artery calcification in lung cancer screening. Transl Lung Cancer Res. 2018;7(3):361-7.
Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schopf UJ. CT of coronary artery disease. Radiology. 2009;253(2):317-38.
Sun Z. Cardiac CT imaging in coronary artery disease: current status and future directions. Quant Imaging Med Surg. 2012;2(2):98-105.
Liu W, Zhang Y, Yu C, Ji Q, Cai M, Zhao Y, et al. Current understanding of coronary artery calcification. J Geriatr Cardiol. 2015;12(6):668-75.
Morri H, Torii S, Kutyna M, Sakamoto A, Finn AV, Virmani R. Coronary artery calcification and its progression: what does it really mean? JACC: Cardiovasc Imaging. 2018;11(1):127-42.
Gupta VA, Leung SW, Winkler MA, Sorrell VL. Identifying coronary artery calcification on non-gated computed tomography scans. J Vis Exp. 2018;138:57918.
Detrano R, Guerci AD, Car JJ, Bild DE, Burke G, Folosom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358(13):1336-45.
Fan L, Fan K. Lung cancer screening CT-based coronary artery calcification in predicting cardiovascular events: a systematic review and meta-analysis. Medicine (Baltimore). 2018;97(20):e10461.
Rasmussen T, Kober L, Abdulla J, Pedersen JH, Wille MMW, Dirksen A, et al. Coronary artery calcification detected in lung cancer screening predicts cardiovascular death. Scand Cardiovasc J. 2015;49(3):159-67.
Pelandre GL, Sanches NMP, Nacif MS, Marchiori E. Detection of coronary artery calcification with nontriggered computed tomography of the chest. Radiol Bras. 2018;51(1):8-12.
Gan Q, Smith KR, Hammond SK, Hu T. Disease burden of adult lung cancer and ischaemic heart disease from passive tobacco smoking in China. Tob Control. 2007;16(6):417-22.
Lehmann N, Mohlenkamp S, Mahabadi AA, Schmermund A, Roggenbuck U, Seibel R, et al. Effect of smoking and other traditional risk factors on the onset of coronary artery calcification: results of the Heinz Nixdorf recall study. Atherosclerosis. 2014;232:339-45.
Thun MJ, Carter BD, Feskanich D, Freedman ND. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013;368:351-64.
Wang K, Eblan MJ, Deal AM, Lipner M, Zagar TM, Wang Y, et al. Cardiac toxicity after radiotherapy for stage iii non–small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 gy. J Clin Oncol. 2017;35(13):1387-94.
Dess RT, Sun Y, Matuszak MM. Cardiac events after radiation therapyL combined analysis of prospective multicenter trials for locally advanced non-small-cell lung cancer. J Clin Oncol. 2017;35:1395-1402.
Dieckmann KP, Gerl A, Witt J, Hartmann JT. Myocardial infarction and other major vascular events during chemotherapy for testicular cancer. Ann Oncol. 2010;21:1607-11.
Starling N, Rao S, Cunningham D. Thromboembolism in patients with advanced gastroesophageal cancer treated with anthracycline, platinum, and fluoropyrimidine combination chemotherapy: a report form the UK National Cancer Research Institute Upper Gastrointestinal Clinical Studies Group. J Clin Oncol. 2009;27:3786-93.
De Bruin MI, Dorrestein LD, van t Veer MB. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma. J Natl Cancer Inst. 2009;101:928-37.
Kravchenko J, Berry M, Arbeev K, Lyerly, HK, Yashin A, Akushevich I. Cardiovascular comorbidities and survival of lung cancer patients: Medicare data based analysis. Lung Cancer. 2015;88(1):85-93.
Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004;43:1731–7.
Whitlock MC, Yeboah J, Burke GL, Chen H, Klepin HD, Hundley WG. Cancer and its association with the development of coronary artery calcification: an assessment from the multi-ethnic study of atherosclerosis. J Am Heart Assoc. 2016;4(11):e002533.
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