PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma
Abstract: Anthracycline-mediated cardiotoxicity is a common concern after lymphoma therapy, particularly in patients with high cardiovascular risk (CVR). In noncancer populations, coronary artery calcium scoring (CACS) effectively identifies individuals who may benefit from aggressive CVR modificati...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952924006748 |
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| author | Genevieve Douglas Zoe Loh Evonne S.Y. Shum Sze-Ting Lee Niamh Waters Garry Hamilton Geoffrey Chong Alexandra C. Murphy Eliza A. Hawkes |
| author_facet | Genevieve Douglas Zoe Loh Evonne S.Y. Shum Sze-Ting Lee Niamh Waters Garry Hamilton Geoffrey Chong Alexandra C. Murphy Eliza A. Hawkes |
| author_sort | Genevieve Douglas |
| collection | DOAJ |
| description | Abstract: Anthracycline-mediated cardiotoxicity is a common concern after lymphoma therapy, particularly in patients with high cardiovascular risk (CVR). In noncancer populations, coronary artery calcium scoring (CACS) effectively identifies individuals who may benefit from aggressive CVR modification to lower the risk of cardiovascular events. Emerging evidence suggests that CACS can also predict cancer therapy-related cardiotoxicity, potentially identifying candidates for cardioprotective strategies. Our study aimed to evaluate whether CACS obtained from pretreatment positron emission tomography (PET)/computed tomography (CT) scans could stratify cardiac event risk in patients with lymphoma receiving anthracycline-based chemotherapy. We enrolled 358 consecutive patients with lymphoma treated between 2012 and 2022, calculating the CACS from their pretreatment PET/CT. We reviewed medical records to identify pre-existing cardiac conditions, CVR, and posttreatment cardiac events, including coronary events, heart failure (HF), and arrhythmias. Logistic and Cox regression models were used to assess associations between CVR, CACS categories (CACS = 0, CACS 1-400, CACS >400), and new cardiac events. At a median follow-up of 27 months (95% confidence interval [CI], 22.3-31.7) in patients without cardiac history, 10% experienced posttreatment cardiac events (HF, 14; arrhythmias, 9; coronary event, 1; combination, 8). Patients with a CACS >0 had more events (21 total, 20% vs 11 total, 5.4% for CACS = 0; P < .001). Elevated CACS was independently associated with HF (CACS 1-400: odds ratio [OR], 3.73; 95% CI, 1.21-11.43; P = .022; CACS >400: OR, 5.43; 95% CI, 1.47-20.03; P = .011) and any cardiac event (CACS 1-400: OR, 2.48; 95% CI, 1.02-6.04; P = .045; CACS >400: OR, 3.28; 95% CI, 0.91-10.68; P = .029). CACS may effectively stratify patients with lymphoma at risk of cardiac complications, thereby identifying a group poised to benefit from targeted preventive strategies. |
| format | Article |
| id | doaj-art-875d64b7b1a043d1bb3f65ce9e93253e |
| institution | Kabale University |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Advances |
| spelling | doaj-art-875d64b7b1a043d1bb3f65ce9e93253e2025-01-30T05:14:48ZengElsevierBlood Advances2473-95292025-02-0193499506PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphomaGenevieve Douglas0Zoe Loh1Evonne S.Y. Shum2Sze-Ting Lee3Niamh Waters4Garry Hamilton5Geoffrey Chong6Alexandra C. Murphy7Eliza A. Hawkes8Department of Clinical Haematology, Austin Health, Heidelberg, Australia; Correspondence: Genevieve Douglas, Department of Clinical Haematology, Austin Health, 145 Studley Rd, Heidelberg 3084, Australia;Department of Clinical Haematology, Austin Health, Heidelberg, AustraliaDepartment of Molecular Imaging and Therapy, Austin Health, Heidelberg, AustraliaDepartment of Molecular Imaging and Therapy, Austin Health, Heidelberg, Australia; Lymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, Australia; Department of Medicine, University of Melbourne, Melbourne, AustraliaLymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, AustraliaLymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, Australia; Department of Cardiology, Austin Health, Heidelberg, AustraliaLymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Medical Oncology, Austin Health, Heidelberg, AustraliaLymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, Australia; Department of Cardiology, Austin Health, Heidelberg, AustraliaDepartment of Clinical Haematology, Austin Health, Heidelberg, Australia; Lymphoma Clinical Innovations Group, Olivia Newton John Cancer and Research Institute, Austin Health, Heidelberg, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Medical Oncology, Austin Health, Heidelberg, Australia; Department of Public Health and Preventative Medicine, Monash University, Melbourne, AustraliaAbstract: Anthracycline-mediated cardiotoxicity is a common concern after lymphoma therapy, particularly in patients with high cardiovascular risk (CVR). In noncancer populations, coronary artery calcium scoring (CACS) effectively identifies individuals who may benefit from aggressive CVR modification to lower the risk of cardiovascular events. Emerging evidence suggests that CACS can also predict cancer therapy-related cardiotoxicity, potentially identifying candidates for cardioprotective strategies. Our study aimed to evaluate whether CACS obtained from pretreatment positron emission tomography (PET)/computed tomography (CT) scans could stratify cardiac event risk in patients with lymphoma receiving anthracycline-based chemotherapy. We enrolled 358 consecutive patients with lymphoma treated between 2012 and 2022, calculating the CACS from their pretreatment PET/CT. We reviewed medical records to identify pre-existing cardiac conditions, CVR, and posttreatment cardiac events, including coronary events, heart failure (HF), and arrhythmias. Logistic and Cox regression models were used to assess associations between CVR, CACS categories (CACS = 0, CACS 1-400, CACS >400), and new cardiac events. At a median follow-up of 27 months (95% confidence interval [CI], 22.3-31.7) in patients without cardiac history, 10% experienced posttreatment cardiac events (HF, 14; arrhythmias, 9; coronary event, 1; combination, 8). Patients with a CACS >0 had more events (21 total, 20% vs 11 total, 5.4% for CACS = 0; P < .001). Elevated CACS was independently associated with HF (CACS 1-400: odds ratio [OR], 3.73; 95% CI, 1.21-11.43; P = .022; CACS >400: OR, 5.43; 95% CI, 1.47-20.03; P = .011) and any cardiac event (CACS 1-400: OR, 2.48; 95% CI, 1.02-6.04; P = .045; CACS >400: OR, 3.28; 95% CI, 0.91-10.68; P = .029). CACS may effectively stratify patients with lymphoma at risk of cardiac complications, thereby identifying a group poised to benefit from targeted preventive strategies.http://www.sciencedirect.com/science/article/pii/S2473952924006748 |
| spellingShingle | Genevieve Douglas Zoe Loh Evonne S.Y. Shum Sze-Ting Lee Niamh Waters Garry Hamilton Geoffrey Chong Alexandra C. Murphy Eliza A. Hawkes PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma Blood Advances |
| title | PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma |
| title_full | PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma |
| title_fullStr | PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma |
| title_full_unstemmed | PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma |
| title_short | PET/CT-derived coronary calcium score may predict cardiac complications in anthracycline-treated patients with lymphoma |
| title_sort | pet ct derived coronary calcium score may predict cardiac complications in anthracycline treated patients with lymphoma |
| url | http://www.sciencedirect.com/science/article/pii/S2473952924006748 |
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