An imaging procedure commonly performed before starting cancer treatment can provide valuable clues about a patient’s risk for heart problems in the months and years after treatment. However, this information is not always report and is rarely act upon in current practice; according to research being present at the American College of Cardiology’s 68th Annual Scientific Session.
Patients on therapy
Doctors frequently order a computed tomography (CT) scan, a special type of X-ray imaging that provides a detailed view inside the body, to assess a tumor’s size and spread before starting patients on therapy. Even though these CT scans also provide a clear view of plaque buildup in the heart’s arteries; the new study found that radiologists only reported this about half the time.
If this reporting was done routinely; it could potentially help doctors identify and treat patients who have coronary plaque buildup and are at high risk for other heart problems; researchers said. “This is essentially free information because the patients are undergoing the CT scans anyway; and we’d like to see it reported more frequently;” said Matthew Hooks, MD; a resident physician at the University of Minnesota and the study’s lead author.
“It would be particularly helpful to know if a patient has evidence of early coronary artery disease before starting cancer treatment that can potentially harm the heart.” Certain chemotherapy drugs and even some of the newer targeted therapies can damage the heart and lead to diseases such as heart failure; especially in people who have coronary artery disease before beginning therapy.
The amount of hardening, or calcification, in the coronary arteries; which is visible on a CT scan; is an important marker of heart health. If a person has high coronary artery calcium (CAC); taking medications such as aspirin or statins can help reduce the risk of a heart attack or other heart problems later.
“As cancer treatments have improved and more patients are surviving cancer; They have become more aware of how these therapies might affect patients’ heart health in the long term;” Hooks said. “We hope to find out whether we can use CAC as a predictive tool to identify patients who may have poor cardiac outcomes and potentially guide the type of chemotherapy they get or guide whether preventative measures should be implemented prior to starting chemotherapy.”
In a sample of 1,001 patients undergoing treatment for cancer; the researchers examin how often CAC is report and how often patients with CAC are prescribe aspirin or statins to reduce cardiovascular risk. All the patients include in the study underwent a CT scan before starting treatment with an anthracycline drug or trastuzumab; two cancer treatments known to increase the risk of heart problems. The research team examine each CT scan to assess CAC and separately determine whether the CAC had been note in the original CT report.