Radiation-induced coronary artery calcification in breast cancer: insights from a systematic review and meta-analysis.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2025-08-26 DOI:10.1097/MCA.0000000000001570

Nima Rahimi Petrudi, Shiva Rahimi Petroudi, Mohammad Reza Rajabi, Hossein Farshidi, Jalal Hassanshahi

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引用次数: 0

Abstract

Radiation therapy for breast cancer increases the risk of coronary artery disease by promoting atherosclerotic plaques. However, the extent of changes in coronary artery calcification (CAC) scores postradiation and the influencing factors remain unclear. This systematic review and meta-analysis evaluated studies investigating changes in CAC scores following breast cancer radiation therapy. Data abstraction was independently performed by two unblinded reviewers using structured collection forms, with no divergences in data collection. The nine-star Newcastle-Ottawa Scale scoring system assessed methodological quality. Statistical analysis was conducted using Comprehensive Meta-Analysis software. Among eight studies (1972 patients), radiation doses ranged from 47 to 60 Grays. The overall rate of CAC score increase or new appearance postradiation was 25.8% [95% confidence interval (CI), 21.3-30.8%]. The rate was significantly higher after left-sided radiation at 32.3% (95% CI, 25.7-39.6%) compared to 16.1% (95% CI, 5.8-37.3%) for right-sided radiation. CAC score development occurs in approximately one-quarter of breast cancer patients after radiation therapy, with a significantly higher risk following left-sided radiation. These findings underscore the need for tailored monitoring strategies to mitigate cardiovascular risks in this population.

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辐射诱发的乳腺癌冠状动脉钙化：来自系统回顾和荟萃分析的见解。

乳腺癌的放射治疗通过促进动脉粥样硬化斑块而增加冠状动脉疾病的风险。然而，冠状动脉钙化（CAC）评分在放疗后的变化程度及其影响因素尚不清楚。本系统综述和荟萃分析评估了调查乳腺癌放疗后CAC评分变化的研究。数据抽象由两名非盲审稿人使用结构化的收集表格独立完成，数据收集没有分歧。九星级纽卡斯尔-渥太华评分系统评估了方法质量。采用综合meta分析软件进行统计分析。在8项研究（1972名患者）中，辐射剂量从47至60格瑞不等。术后CAC评分升高或新外观的总发生率为25.8%[95%可信区间（CI）， 21.3-30.8%]。左侧放射后的发生率明显高于右侧放射后的16.1% (95% CI, 5.8-37.3%)，为32.3% （95% CI, 25.7-39.6%）。大约四分之一的乳腺癌患者在放射治疗后出现CAC评分，左侧放射治疗后的风险明显更高。这些发现强调需要量身定制的监测策略来降低这一人群的心血管风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.