Cardiovascular (CV) disease is common among men with prostate cancer and the leading cause of death in this population. There is a need for CV risk assessment tools that can be easily implemented in the prostate cancer treatment setting.
Consecutive patients who underwent positron emission tomography/computed tomography (PET/CT) for recurrent prostate cancer at a single institution from 2012 to 2017 were identified retrospectively. Clinical data and coronary calcification on nongated CT imaging were obtained. The primary outcome was major adverse CV event (MACE; myocardial infarction, coronary or peripheral revascularization, stroke, heart failure hospitalization, or all-cause mortality) occurring within 5 years of PET/CT.
Among 354 patients included in the study, there were 98 MACE events that occurred in 74 patients (21%). All-cause mortality was the most common MACE event (35%), followed by coronary revascularization/myocardial infarction (26%) and stroke (19%). Coronary calcification was predictive of MACE (HR = 1.9, 95% CI: 1.1-3.4, P = .03) using adjusted Kaplan-Meier analysis. As a comparator, the Framingham risk score was calculated for 198 patients (56%) with complete clinical and laboratory data available. In this subgroup, high baseline Framingham risk (corresponding to 10-year risk of CV disease > 20%) was not predictive of MACE.
MACE was common (21%) in men with recurrent prostate cancer undergoing PET/CT over 5 years of follow-up. Incidental coronary calcification on PET/CT was associated with increased risk of MACE and may have utility as a CV risk predictor that is feasible to implement among all prostate cancer providers.
Clinical genitourinary cancer. 2024 Jan 22 [Epub ahead of print]
Preet A Shaikh, Avira Som, Elena Deych, Alison J Deng, Melissa A Reimers, Brian C Baumann, Eric H Kim, Daniel J Lenihan, Kathleen W Zhang
Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Division of Oncology, Section of Medical Oncology, Washington University School of Medicine, St. Louis, MO., Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO., Department of Urology, Washington University School of Medicine, St. Louis, MO., Division of Cardiology, St. Francis Health, Cape Girardeau, MO., Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: .