Prediction of Cardiac Toxicity by Measurement of Coronary Artery Calcium Scoring Method Using Chest Computed Tomography in Early Breast Cancer Patients Treated with Trastuzumab

Breast care

article

Yoon, Chang Ik¹  Chang, Suyon²  Park, Jeaneum²  Kim, Dooreh¹  Lee, Young Joo¹  Bae, Soo Youn¹  Park, Woo-Chan¹ 

[1]Division of Breast Surgery, Department of Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea

[2]Department of Radiology, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea

关键词: Breast cancer;    Trastuzumab;    Human epidermal growth factor receptor 2;    Cardiac toxicity;    Coronary calcium artery;   

DOI  :  10.1159/000527683

学科分类：泌尿医学

来源: S Karger AG

【 摘 要 】

Background: In human epidermal growth factor receptor 2 (HER2)-positive early stage breast cancer, prediction of trastuzumab-related cardiac toxicity remains a challenge. The coronary calcium artery (CAC) reflects the total coronary plaque burden, which predicts the risk of atherosclerosis. We investigated the prediction of left ventricular ejection fraction (LVEF) decline in breast cancer according to CAC scores. Methods: A total of 347 patients were enrolled from Seoul St Mary’s Hospital between January 2010 and December 2019. Chest computed tomography (CT) was performed at a single tertiary center. Patients who received trastuzumab for HER2-positive early breast cancer were included in this study. Results: Of the 347 patients, 312 and 35 had CAC scores of 0 and ≥1, respectively. The CAC ≥1 group was associated with older age, body mass index, and receipt of left breast irradiation. The CAC ≥1 group was significantly associated with LVEF decline (absolute value, ≤50%) (hazard ratio [HR] 12.038, 95% confidence interval [CI] 2.845–50.937, p = 0.001), LVEF decline (absolute value, ≤55%) (HR 4.439, 95% CI: 1.787–11.028, p = 0.001), and decline in LVEF of ≥10% points compared with baseline echography (HR 5.083, 95% CI: 1.658–15.582, p = 0.004). Even after adjusting for other clinical factors, CAC ≥1 remained a significant predictor of decreased LVEF. Conclusion: Our findings suggest that the CAC score is a significant predictor of cardiac toxicity following trastuzumab treatment in HER2-positive breast cancer. Therefore, CAC measurement could reduce cardiac toxicity by distinguishing patients at high risk for trastuzumab.

【 授权许可】

CC BY