Detected coronary calcification goes unreported in 50% of CT scans for cancer

Matthew C. Hooks

NEW ORLEANS — Roughly half of patients with cancer who had coronary artery calcification detected in CT scans were clinically reported in electronic medical records, according to data presented at the American College of Cardiology Scientific Session.

“Evaluating cancer CT scans for CAC is essentially free information and poses no further risk to the patient,” Matthew C. Hooks, MD, a resident physician at the University of Minnesota in Minneapolis, told Cardiology Today. “There are guidelines on reporting of CAC on such CT scans, and then treatment algorithms based on presence and extent of CAC. We as physicians taking care of cancer patients need to do a better job at reporting CAC and then acting on it.”

Researchers analyzed data from 1,001 patients (mean age, 62 years; 38% men) with cancer who were treated with anthracycline and/or trastuzumab (Herceptin, Genentech). Patients underwent CT for cancer staging before treatment. EMRs were reviewed in patients with CAC in CT scans (n = 349) to determine whether calcification was reported and whether it resulted in any clinical action.

Some of the most common cancers seen in patients in this study included breast cancer (28%), lymphoma (22%) and sarcoma (12%).

CAC was clinically reported in 51% of patients who had it detected in CT scans. Of the patients with CAC in CT scans, 44% were on aspirin, 16% had known CAD and 46% were on statin therapy at the time of the scan.

Before receiving cancer treatment, 24 patients with CAC were referred to a cardiologist, and 10 of those patients were referred for primary prevention of CVD. In addition, five patients started aspirin therapy and three patients started statin therapy.

Roughly half of patients with cancer who had coronary artery calcification detected in CT scans were clinically reported in electronic medical records, according to data presented at the American College of Cardiology Scientific Session.

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“While it is well known that CAC predicts worse cardiac outcomes in the general population, it is not known whether CAC has the same predictive power in cancer patients,” Hooks said in an interview. “We are working on that research currently. If correlation is present, CAC on screening CT scans could guide the type of chemotherapy patients receive and whether primary preventative measures should be implemented.” – by Darlene Dobkowski

Reference:

Hooks MC, et al. Abstract 1331-416. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.

Disclosure: Hooks reports no relevant financial disclosures.