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Abstract 611: Association Between Thoracic Irradiation and Increased Progression of Coronary Artery Calcium

Title: Abstract 611: Association Between Thoracic Irradiation and Increased Progression of Coronary Artery Calcium
Authors: Davison, Mark A; Yakupovich, Anel; Kharouta, Michael Z; Turian, Julius; Seder, Christopher W; Batus, Marta; Kalra, Dinesh; Kosinski, Mark; Taskesen, Tuncay; Okwuosa, Tochukwu M
Source: Arteriosclerosis, Thrombosis, and Vascular Biology ; volume 38, issue Suppl_1 ; ISSN 1079-5642 1524-4636
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2018
Description: Introduction: Thoracic irradiation (TIR) is associated with increased risk of coronary artery disease (CAD) and coronary death. Coronary artery calcium (CAC) is the result of coronary plaque accumulation and has been shown to predict CAD and overall cardiovascular mortality. We hypothesized that TIR in lung cancer patients receiving radiotherapy would be associated with CAC progression. Methods: We evaluated CAC progression (pre- and post-TIR) from chest CT scans of lung cancer patients identified from a cancer registry at an urban academic medical center. A 2:1 matched control population was established controlling for age, gender, race, and CT scan interval. Vessel-specific CAC progression and extension in pre- and post-interval CT studies was evaluated by 2 independent reviewers using existing standard methodologies. Whole heart and the left anterior descending (LAD) coronary artery were retrospectively segmented on the CT study used for treatment planning. The volume of each structure and associated dose metrics were obtained using the standard tools available in the Pinnacle Treatment Planning software. Chi squared tests were used to compare vessel-specific CAC progression (increase in CAC volume) and extension (CAC lengthening within a vessel) between groups. Pearson correlation analysis explored associations between radiation volume and CAC progression. Results: We included 35 patients and 65 controls (50% female). Mean and max whole heart TIR doses: 13.5 Gy (95% CI 10.3-16.7 Gy) and 52.1 Gy (95% CI 46.2 – 58.0 Gy); LAD: 21.4 Gy (95% CI 16.0 – 26.8 Gy) and 34.9 Gy (95% CI 28.7 – 41.1 Gy), respectively. CAC progression and extension in LAD and left circumflex coronary artery (LCx) were significantly greater in patients vs. controls ( p
Document Type: article in journal/newspaper
Language: English
DOI: 10.1161/atvb.38.suppl_1.611
Availability: https://doi.org/10.1161/atvb.38.suppl_1.611; http://journals.lww.com/00043605-201805001-00438
Accession Number: edsbas.13ECC1C2
Database: BASE