CT-Defined Coronary Artery Calcification may predict overall survival and major CV events in Lung Cancer patients: Study

Lung cancer is the leading cause of increased morbidity and mortality globally. Computed Tomography (CT) scan is used for diagnosing, staging, and assessing the prognosis of lung cancer. Literature shows that Coronary artery calcification (CAC) can be used to diagnose and quantify v=cardiovascular diseases using a CT scan. Agatston score is used to quantify CAC based on the cardiac-gated CT images. Previous studies showed that artificial intelligence algorithms can calculate CAC scores in oncology patients. As there is ambiguity in using the CAC score in lung cancer, researchers have conducted a systematic review to establish the effect of the CAC score on overall survival (OS) in lung cancer patients.

Literature databases like the MEDLINE library, Google Scholar, and SCOPUS databases were screened for papers analyzing the association between CAC and overall survival in lung cancer patients up to June 2024. The study included lung cancer patients in whom CT can define CAC for the overall survival of major adverse cardiac events. The primary endpoint of the systematic review was overall survival (OS) presented as hazard ratio for CAC with a reported 95% confidence interval and p-value in univariable and multivariable analyses.

Findings:

• The included studies comprised 2292 patients undergoing curative treatment.
• The pooled hazard ratio for the association between CAC score and OS was HR= 1.42 (95% CI=(1.19; 1.69), p < 0.0001) in the univariable analysis and HR= 1.56 in the multivariable analysis.
• A higher CAC score was associated with poor overall survival.
• The pooled odds ratio for the association between CAC score and major cardiovascular events was OR= 1.97.
• A higher CAC score was found to be strongly associated with an increased likelihood of MACE

Thus, the study concluded that the CAC score can be used as a good predictive tool for overall survival and the occurrence of major cardiovascular events. A CT-defined CAC score significantly influences overall survival and strongly predicts major adverse cardiovascular events. Researchers emphasized adding CAC to radiological reporting in lung cancer patients to assess the prognosis. The study highlights the potential outcomes that can be obtained by multidisciplinary care by promoting cardioprotective interventions along with oncological care for Lung cancer.

Further reading: Meyer HJ, Wienke A, Surov A. CT-Defined Coronary Artery Calcification as a Prognostic Marker for Overall Survival in Lung Cancer: A Systematic Review and Meta-analysis. Acad Radiol. Published online November 18, 2024. doi:10.1016/j.acra.2024.10.046