Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer
Authors' conclusion
Post-therapy (C2AD2) and pre-therapy (C2AD) models are simple, easy to use and effective tools to stratify breast and lung cancer patients undergoing chest radiation for post-RT MACCE.
Study context
- Population
- Lung/breast cancer patients who had chest radiation therapy (RT) with planning CT at Mayo Clinic, 01/2010–01/2014derivation 406 lung + 711 breast
- Exposure
- Low vs Intermediate vs High
- Outcome
- Post-RT MACCE
- Follow-up
- Mean 42 ± 13 months
Methodological detailsrisk prediction model development and validation, single-centre, derivation and validation cohorts
- Risk prediction model development and validation
- Single-centre
- Derivation and validation cohorts
Main finding
As reported in the abstract
Post-RT MACCE by risk group, post-therapy model (C2AD2: Coronary artery calcification (CAC) 2, MACCE history 2, age ≥74 3, DM 2, mean heart dose ≥ 850 mGy 2 points)
| Group | Value | Validation cohort |
|---|---|---|
| Low risk | 2.7 % | 3.9 |
| Intermediate risk | 8.9 % | 6.6 |
| High risk | 19.8 % | 16.4 |
Value
Low risk2.7 %
Intermediate risk8.9 %
High risk19.8 %
Validation cohort
Low risk3.9
Intermediate risk6.6
High risk16.4
Observational data: associations, not effects.
Further findings
Post-RT MACCE by risk group, pre-therapy model (C2AD: post-therapy parameters minus mean heart dose) · value = derivation cohort
Validation cohort Low risk 3.7 · Intermediate risk 9.2 · High risk 13.2
Overall post-RT major adverse cardiovascular and cerebrovascular events (MACCE) incidence · mean follow-up 42 ± 13 months
- Derivation cohort
- 6.1%
- Validation cohort
- 5.6%
Original publication
Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer. Eur J Prev Cardiol. Published 25 October 2024. doi:10. 1093/ eurjpc/ zwae323
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