Prognostic significance of abdominal aortic calcification scores on dual-energy X-ray absorptiometry scans for mortality in cancer survivors: NHANES-based cohort study (2013-2019)
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View abstract on PubMed
Summary
This summary is machine-generated.Abdominal aortic calcification (AAC) in cancer survivors aged 40+ is linked to higher risks of death from any cause and cardiovascular events. DXA scans can help identify survivors needing closer monitoring for these risks.
Area Of Science
- Cardiology
- Oncology
- Radiology
Background
- Abdominal aortic calcification (AAC) signifies systemic atherosclerosis and predicts cardiovascular (CV) events in the general population.
- Cancer survivors face increased risks for adverse CV outcomes, necessitating better risk stratification tools.
Purpose Of The Study
- To investigate the association between abdominal aortic calcification (AAC) and both all-cause and cardiovascular (CV) mortality in a large cohort of US cancer survivors.
- To determine if AAC, assessed via DXA scans, can serve as a prognostic marker in the cardio-oncology setting.
Main Methods
- Utilized 7 years of data (2013-2019) from the National Health and Nutrition Examination Survey (NHANES) for a nationally representative sample of US cancer survivors (aged ≥40).
- Quantified AAC burden using Kauppila AAC-24 scores derived from dual-energy X-ray absorptiometry (DXA) scans.
- Employed Kaplan-Meier curves and multivariable Cox/Fine and Gray models to analyze associations between AAC and mortality outcomes, adjusting for various confounders.
Main Results
- The study included over 23 million cancer survivors, with 46% exhibiting AAC and 19.5% showing severe AAC (AAC-24 > 6).
- Each one-unit increase in AAC-24 score was significantly associated with increased risks of all-cause mortality (aHR 1.04, P=0.047) and CV mortality (aS HR 1.07, P=0.002).
- These associations remained significant after adjusting for demographic, socioeconomic, CV risk factors, comorbidities, and cancer-specific characteristics.
Conclusions
- Abdominal aortic calcification identified on DXA scans is an independent predictor of elevated all-cause and cardiovascular mortality in cancer survivors aged 40 and older.
- DXA-based AAC assessment offers a valuable tool for risk stratification within cardio-oncology, aiding in the management of cancer survivors.
- This finding highlights the importance of evaluating subclinical atherosclerosis in cancer survivors to mitigate long-term CV risks.
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