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The researches find that the computed tomography (CT) imaging at diagnosis to assess their risk of cardiovascular disease (CVD) rather than relying on body mass index (BMI), say US investigators; as it is a better indicator of outcomes. Justin C. Brown, PhD; director of the Cancer Metabolism Program at Pennington Biomedical Research Center, Baton Rouge, Louisiana, and colleagues looked at the records of over 2800 CRC survivors treated in the Kaiser Permanente health system.

Cancer Metabolism Program

As expected, these patients had a high rate of cardiovascular events; at a 10-year cumulative incidence of the composite major adverse cardiovascular events (MACE) of cardiovascular mortality; nonfatal myocardial infarction, and nonfatal stroke of almost 20%. However; body mass index (BMI) was unrelated to the occurrence of MACE.

Instead, the researchers find that visceral adiposity obtained from CT imaging take at diagnosis is significantly associated with cardiovascular outcomes. Patients with the highest levels of abdominal fat were more than 50% more likely to experience MACE over almost 7 years of follow-up.

CT imaging at diagnosis

In addition, muscle radiodensity; which reflects the amount of lipid stored in skeletal muscle; is inversely associate with MACE, such that patients with the highest muscle density had a 33% reduced risk vs those with the lowest. For CRC patients; who are already undergoing CT imaging at diagnosis; Brown said that “one of the rather exciting developments in this area is there are now automated techniques that can very precisely quantify the amount of muscle and fat from these CT images.”

The idea is that, eventually, when patients undergo CT imaging to potentially identify a cancer; “the radiology workflow in their report will also say: here are the estimates of the visceral fat; here are the estimates of the muscle.” Brown noted: “As this study has shown; these are important metrics to report that could influence clinical decision making, because of their prognostic importance.”

Influence clinical decision

“They measure blood pressure, we take the pulse; my hope is that in the near future we’ll be measuring these body composition metrics just like we do these other indicators of health;” he added. Brown said that “a lot of the focus to date has been on the risk of cancer occurrence; and that certainly is of great importance because that is the number one cause of morbidity and mortality in this population, but number two is cardiovascular disease. “All patients had undergone abdominal or pelvic CT scanning at diagnosis and surgical resection of their CRC; and had valid body mass measures. Patients with a history of myocardial infarction or stroke prior to CRC diagnosis were excluded.