Coronary vasomotor dysfunction portends worse outcomes in patients with breast cancer.
Cancer survivorship
Cardio-oncology
Coronary artery calcium
Coronary microvascular disease
Myocardial flow reserve
Positron emission tomography
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
08
07
2021
accepted:
17
09
2021
pubmed:
26
11
2021
medline:
14
1
2023
entrez:
25
11
2021
Statut:
ppublish
Résumé
Impaired MFR in the absence of flow-limiting CAD is associated with adverse events. Cardiovascular disease is an important cause of morbidity and mortality in patients with breast cancer. We sought to test the utility of MFR to predict outcomes in a cohort of patients with breast cancer. We retrospectively studied consecutive patients with breast cancer or breast cancer survivors who underwent cardiac stress PET imaging from 2006 to 2017 at Brigham and Women's Hospital. Patients with a history of clinically overt CAD, LVEF < 45%, or abnormal myocardial perfusion were excluded. Subjects were followed from time of PET to the occurrence of a first major adverse cardiovascular event (MACE) and all-cause death. The final cohort included 87 patients (median age 69.0 years, 98.9% female, mean MFR 2.05). Over a median follow-up of 7.6 years after PET, the lowest MFR tertile was associated with higher cumulative incidence of MACE (adjusted subdistribution hazard ratio 4.91; 95% CI 1.68-14.38; p = 0.004) when compared with the highest MFR tertile. In patients with breast cancer, coronary vasomotor dysfunction was associated with incident cardiovascular events. MFR may have potential as a risk stratification biomarker among patients with/survivors of breast cancer.
Sections du résumé
BACKGROUND
Impaired MFR in the absence of flow-limiting CAD is associated with adverse events. Cardiovascular disease is an important cause of morbidity and mortality in patients with breast cancer. We sought to test the utility of MFR to predict outcomes in a cohort of patients with breast cancer.
METHODS
We retrospectively studied consecutive patients with breast cancer or breast cancer survivors who underwent cardiac stress PET imaging from 2006 to 2017 at Brigham and Women's Hospital. Patients with a history of clinically overt CAD, LVEF < 45%, or abnormal myocardial perfusion were excluded. Subjects were followed from time of PET to the occurrence of a first major adverse cardiovascular event (MACE) and all-cause death.
RESULTS
The final cohort included 87 patients (median age 69.0 years, 98.9% female, mean MFR 2.05). Over a median follow-up of 7.6 years after PET, the lowest MFR tertile was associated with higher cumulative incidence of MACE (adjusted subdistribution hazard ratio 4.91; 95% CI 1.68-14.38; p = 0.004) when compared with the highest MFR tertile.
CONCLUSIONS
In patients with breast cancer, coronary vasomotor dysfunction was associated with incident cardiovascular events. MFR may have potential as a risk stratification biomarker among patients with/survivors of breast cancer.
Identifiants
pubmed: 34820770
doi: 10.1007/s12350-021-02825-1
pii: 10.1007/s12350-021-02825-1
pmc: PMC9126993
mid: NIHMS1764424
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3072-3081Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL094301
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG031679
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL135438
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL130563
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL132021
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. American Society of Nuclear Cardiology.
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