Evaluating coronary arteries and predicting MACEs using CCTA in lung cancer patients receiving chemotherapy or chemoradiotherapy

• Published in: Radiotherapy and oncology 2024-11, Vol.200, p.110498, Article 110498
• Main Authors: Xie, Yuhang, Shen, Hesong, Xu, Qian, Tu, Chunrong, Yang, Rui, Liu, Tao, Tang, Hao, Miao, Zhiming, Zhang, Jiuquan
• Format: Article
• Language: English
• Subjects: Chemotherapy and chemoradiotherapy; Coronary artery; Coronary computed-tomography angiography; Lung cancer; Major adverse cardiovascular events
• ISSN: 0167-8140; 1879-0887; 1879-0887
• DOI: 10.1016/j.radonc.2024.110498

•Compared with the control group, higher CAD-RADS classification, lower CT-FFR, and higher FAI in lung cancer.•CT-FFR decreased and FAI increased after CHT or CRT, and CT-FFR and higher FAI were observed in patients after CRT than CHT.•CT-FFR and FAI before CHT or CRT were associated with MACEs. Whether coronary computed-tomography angiography (CCTA) can detect cancer treatment-related impairments of coronary artery and predict major adverse cardiovascular events (MACEs) in lung cancer patients receiving chemotherapy (CHT) or chemoradiotherapy (CRT) is unclear. This study aimed to evaluate coronary arteries using CCTA parameters and explore the association of these parameters with MACEs in patients with lung cancer receiving CHT or CRT. This study retrospectively collected data from 697 lung cancer patients who received CHT or CRT and underwent CCTA examination within 2 weeks before or after treatment from June 2013 to May 2019. The patients were divided into CHT and CRT group, and for the control group, the propensity score matching (PSM) was used and 125 participants without carcinoma with a single CCTA examination were included. CCTA parameters, assessed using artificial intelligence software, were compared across different groups (control vs. CHT & CRT; CHT vs. CRT). We analyzed associations between CCTA parameters and MACEs using a Cox-regression model and Kaplan–Meier curves to compare MACE-free survival rates. Before CHT or CRT, compared with the control group, in CHT&CRT group we observed higher fat attenuation index (FAI), coronary-artery calcium (CAC) score, CAD-RADS classification, stenosis severity and lower computed-tomography fractional flow reserve (CT-FFR; all P