Association Between Cancer Treatment History and Coronary Inflammation

Previous studies have established a strong link between a cancer history and an increased risk of cardiovascular events.

This study aimed to determine whether a cancer history is independently associated with coronary inflammation, a key driver of atherosclerotic plaque development.

This study included 1141 patients who underwent coronary computed tomography angiography from 2017 to 2018. We divided the patients into 2 groups based on the cancer history: 953 noncancer patients and 188 cancer patients. Coronary inflammation was quantified using the perivascular fat attenuation index (FAI) in the right coronary artery, with high-FAI defined as above the 75th percentile. Multivariable Poisson regression with robust error variance was employed to evaluate the relationship between cancer history and high-FAI, adjusting for conventional cardiovascular risk factors.

The median age and FAI in the overall study population were 70 years and -75.8 HU, respectively. Multivariable analysis revealed a significantly increased prevalence of high-FAI in cancer patients (relative risk [RR]: 1.56; 95% CI: 1.23-1.97) compared to noncancer patients. Stratified analysis based on times after cancer treatment revealed that patients with <5 years postcancer treatment showed a significant association with the prevalence of high-FAI (RR: 1.70; 95% CI: 1.31-2.21) compared to noncancer patients, whereas no significant association was observed between patients with ≥5 years postcancer treatment and high-FAI (RR: 1.29; 95% CI: 0.87-1.92).

In this population, a cancer history, especially in patients with current or recent treatment history, was significantly associated with elevated coronary inflammation.