Coronary artery calcification scoring system based on the coronary artery calcium data and reporting system (CAC-DRS) predicts major adverse cardiovascular events or all-cause death in patients with potentially curable lung cancer without a history of cardiovascular disease

被引：18

作者：

Osawa, Kazuhiro ^{[1
]}

Bessho, Akihiro ^{[2
]}

Fuke, Soichiro ^{[1
]}

Moriyama, Shigeharu ^{[3
]}

Mizobuchi, Asako ^{[1
]}

Daido, Shunsuke ^{[1
]}

Tanaka, Masamichi ^{[1
]}

Yumoto, Akihisa ^{[1
]}

Saito, Hironori ^{[1
]}

Ito, Hiroshi ^{[4
]}

机构：

[1] Japanese Red Cross Okayama Hosp, Dept Cardiovasc Med, Kita Ku, 2-1-1 Aoe, Okayama 7000921, Japan

[2] Japanese Red Cross Okayama Hosp, Dept Resp Med, Okayama, Japan

[3] Japanese Red Cross Okayama Hosp, Dept Thorac Surg, Okayama, Japan

[4] Okayama Univ, Grad Sch Med, Dept Cardiovasc Med Dent & Pharmaceut Sci, Okayama, Japan

来源：

HEART AND VESSELS | 2020年 / 35卷 / 11期

关键词：

Coronary artery calcium data and reporting system; Lung cancer; Coronary artery calcification; Major adverse cardiovascular events; All-cause death; CHEST CT SCANS; AMERICAN-COLLEGE; TASK-FORCE; RISK; MORTALITY;

D O I：

10.1007/s00380-020-01624-x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The coronary artery calcium data and reporting system (CAC-DRS) is a novel reporting system based on CAC severity. Lung cancer patients have a high risk of cardiovascular disease (CVD), for which CAC severity may provide additional prognostic information. Using non-gated, non-contrast computed tomography (CT), we evaluated the CAC-DRS for predicting CVD and all-cause death in patients with potentially curable resected lung cancer. We retrospectively studied 309 consecutive patients without a history of CVD (mean age 67.4 +/- 8.2 years, 61% male) who underwent curative surgery for non-small-cell lung cancer between May 2012 and March 2019 at the Japanese Red Cross Okayama Hospital. Time to incidence of major adverse cardiac events (MACEs) (non-fatal myocardial infarction, non-fatal stroke and cardiovascular death) and all-cause death was analyzed using Fine and Gray and Cox regression models. The CAC-DRS score was assessed using standard chest CT without electrocardiogram gating. During 52-months' median follow-up, 43 patients (13.4%) developed incident MACEs or died from any cause; the pathological cancer stages were Ia (n = 20), Ib (n = 8), IIa (n = 2), IIb (n = 2) and IIIa (n = 11). Patients had a graded increase in incidence of MACEs or all-cause death with increasing categories of CAC-DRS. The CAC-DRS score was significantly associated with incident MACEs or all-cause death after adjusting for confounding factors (hazard ratio 1.18; 95% confidence interval 1.10-1.25, p < 0.01). In conclusion, the CAC-DRS score on non-gated standard CT can predict incident MACEs and/or all-cause death in patients with potentially curable resected lung cancer. Lung cancer survivors with a greater CAC-DRS category may need more active management of cardiovascular risk factors.

引用

页码：1483 / 1493

页数：11

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