Subclinical Atherosclerosis and Cardiovascular Events Among Patients With Colorectal Cancer.

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Colorectal cancer (CRC) patients face elevated risks of cardiovascular disease (CVD).
• Subclinical atherosclerosis is a key concern in this patient population.

Purpose of the Study:

• To evaluate coronary artery calcium (CAC) as a marker for subclinical atherosclerosis.
• To assess the association between CAC and major adverse cardiovascular events (MACE) in CRC patients throughout their cancer treatment.

Main Methods:

• Adults with newly diagnosed CRC were prospectively enrolled (2017-2024).
• CAC was measured using routine CT and PET-CT scans.
• Fine and Gray models were used to analyze CAC and MACE risk, considering competing risks.

Main Results:

• Among 300 CRC patients, prevalent CVD risk factors included hypertension (37%), hyperlipidemia (24%), and diabetes (14%).
• During a median 5.3-year follow-up, 25% experienced MACE, including stroke, heart failure events, revascularization, and death.
• Baseline CAC was present in 36.6% of 101 patients with baseline imaging and was associated with a significantly higher MACE risk (HR=4.79).

Conclusions:

• Subclinical atherosclerosis, indicated by CAC, and MACE are frequent in CRC patients.
• Integrating CAC assessment from routine cancer imaging can identify CRC patients who would benefit from cardio-preventive interventions.