Several cardiovascular risk factors such as advanced age and smoking history may be prevalent among patients with lung cancer at the time of diagnosis and may increase their risk of future cardiovascular disease, according to findings presented by Malozzi et al at the American College of Cardiology’s (ACC) Advancing the Cardiovascular Care of the Oncology Patient course 2025.
Background
Cardiovascular disease and cancer are the leading causes of mortality in the United States. Smoking is a shared risk factor for lung cancer and cardiovascular disease. Those with existing cardiovascular disease who receive a lung cancer diagnosis may have an increased risk of mortality. Prior research has shown that some treatments for lung cancer, including radiation therapy, could elevate the risk of developing cardiovascular disease.
Study Methods and Results
In this study, researchers assessed 276 patients with lung cancer for existing atherosclerosis on staging computed tomography (CT) scans. They also collected data on the patients’ systolic blood pressure, diastolic blood pressure, pulse pressure, body mass index, age, sex, race, smoking status, and type of lung cancer. Each patient underwent imaging for evaluation and staging of lung cancer.
“The overall goal of the study was to determine the presence of traditional cardiac risk factors in this specific cancer population and to determine the usefulness of available CT imaging in the identification of atherosclerosis present at the time of cancer diagnosis,” explained lead study author Christopher Malozzi, DO, Director of Cardio-Oncology Services at the University of South Alabama Frederick P. Whiddon College of Medicine. “Recognition of cardiac risk factors and atherosclerosis allows for earlier treatment interventions and risk factor modification in these patients,” he added.
The researchers demonstrated that 77.9% of the patients had detectable atherosclerosis on their CT scans. They also revealed that 47.8% of the patients had systolic blood pressure ≥ 130 mm Hg, and 38% of them had diastolic blood pressure ≥ 80 mm Hg. Overall, 27.2% of the patients had obesity, and 88.8% of them were current or former tobacco users.
“Smoking was by far the most prominent cardiac risk factor in this group. This was followed by advancing age, hypertension, and obesity,” Dr. Malozzi detailed.
The researchers emphasized that comprehensive assessments are needed in this vulnerable patient population to improve survival outcomes and the quality of care. Although the study lacked sufficient data to adequately assess the impact of high cholesterol or diabetes, they stressed that these risk factors need to be considered as a result of their relationship with cardiovascular disease.
In addition, the study group performed a similar analysis using CT scans to examine atherosclerosis in patients with gynecologic cancers entering treatment. The researchers found that atherosclerosis was present in nearly 33% of the study participants, indicating a high prevalence of cardiovascular disease. The risk factors examined were largely modifiable.
Conclusions
The researchers indicated that CT scans could be used to detect atherosclerosis of the coronary arteries in the form of calcification within the blood vessels.
“This study suggests it may be reasonable to consider concurrent coronary calcium scoring on imaging obtained for lung cancer staging or screening to aid in identification of atherosclerosis and earlier intervention such as lifestyle, diet, and cardiac risk factor modification education. The use of imaging already available may also reduce the need for additional testing in these patients and cut down overall health-care costs,” Dr. Malozzi concluded.
Disclosure: For full disclosures of the study authors, visit acc.org.
