Trabattoni Daniela, Leonardi Maria Cristina, Mancini Maria Elisabetta, Jereczek-Fossa Barbara A, Cattani Federica, Santagostino Baldi Giulia, Bonomi Alice, Galotta Arianna, Mushtaq Saima, Annoni Andrea, Alio Davide, Vincini Maria Giulia, Fodor Cristiana Iuliana, La Grutta Ludovico, Montorsi Piero, Pontone Gianluca
Centro Cardiologico Monzino, IRCCS, Milan, Italy.
Division of Radiation Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy.
Front Cardiovasc Med. 2025 Aug 4;12:1615793. doi: 10.3389/fcvm.2025.1615793. eCollection 2025.
Patients receiving thoracic radiation (RT) are at increased risk for heart disease. Coronary artery calcium (CAC) is an independent risk factor for cardiac events.
The aim of this prospective, joint-institution, study was to analyze the relationship between cardiovascular risk factors (CVRF) known before breast cancer diagnosis and treatment, and the risk of developing coronary events in women undergoing adjuvant breast radiotherapy by measuring CAC.
Women ( = 92) diagnosed with early-stage breast cancer between 2010 and 2016 were enrolled and underwent cardiologic clinical assessment and coronary CT-scan for CAC score analysis, at least 5 years after RT.
Data obtained from 91/92 patients, showed a 36.2% incidence of pathologic Agatston CAC score, independent of the irradiated breast side. After grouping patients according to the total number of CVRF [group 1, = 55 (60.4%): 0-2 CV risk factors; group 2, = 36 (39.6%): 3-5 CV risk factors] significant differences were observed in CAC scores. Normal CAC scores (Agatston 0) were recorded in 70.9% in group 1 vs. 41.7% in group 2 ( = 0.005), while CAC-3 (Agatston ≥ 300) in 11.1% of group 2 only ( = 0.02), corresponding to clinical evidence of coronary disease. The risk of cardiac events was associated with increased age, early menopause, hypertension, high cholesterol levels, and smoking habits at the time of RT.
This study helps to identify women at high-risk for cardiovascular events before RT and implement the best possible prevention of late post cancer treatment events.
ClinicalTrials.gov, Identifier (NCT05775822).
接受胸部放疗（RT）的患者患心脏病的风险增加。冠状动脉钙化（CAC）是心脏事件的独立危险因素。
这项前瞻性、联合机构研究的目的是，通过测量CAC来分析乳腺癌诊断和治疗前已知的心血管危险因素（CVRF）与接受辅助性乳腺癌放疗的女性发生冠状动脉事件风险之间的关系。
纳入2010年至2016年间诊断为早期乳腺癌的女性（n = 92），并在放疗后至少5年进行心脏临床评估和冠状动脉CT扫描以分析CAC评分。
从91/92例患者获得的数据显示，病理性阿加斯顿CAC评分的发生率为36.2%，与受照射的乳房侧无关。根据CVRF总数对患者进行分组[第1组，n = 55（60.4%）：0 - 2个心血管危险因素；第2组，n = 36（39.6%）：3 - 5个心血管危险因素]，观察到CAC评分存在显著差异。第1组中70.9%的患者记录为正常CAC评分（阿加斯顿0分），而第2组中为41.7%（p = 0.005），而只有第2组的11.1%为CAC-3（阿加斯顿≥300）（p = 0.02），这与冠状动脉疾病的临床证据相符。心脏事件的风险与放疗时年龄增加、早绝经、高血压、高胆固醇水平和吸烟习惯有关。
本研究有助于在放疗前识别心血管事件高危女性，并实施最佳的癌症治疗后晚期事件预防措施。
ClinicalTrials.gov，标识符（NCT05775822）。
