Next generation risk markers in preventive cardio-oncology

Authors

Morgan Lamberg, Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.
Andrea Rossman, Medical College of Wisconsin, Milwaukee, WI, USA.
Alexandra Bennett, Medical College of Wisconsin, Milwaukee, WI, USA.
Sabrina Painter, Department of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Rachel Goodman, Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.
James MacLeod, Medical College of Wisconsin, Milwaukee, WI, USA.
Ragasnehith Maddula, Medical College of Wisconsin, Milwaukee, WI, USA.
David Rayan, Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.
Krishna Doshi, Advocate Aurora HealthFollow
Alexander Bick, Division of Genetic Medicine, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
Simone Bailey, Preventive Cardiology, Rochester Regional Health, Rochester, MN, USA.
Sherry-Ann Brown, Cardio-Oncology & Preventive Cardiology Programs, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. shbrown@mcw.edu.Follow

Recommended Citation

Lamberg M, Rossman A, Bennett A, et al. Next Generation Risk Markers in Preventive Cardio-oncology. Curr Atheroscler Rep. 2022;24(6):443-456. doi:10.1007/s11883-022-01021-x

Affiliations

Advocate Lutheran General Hospital

Abstract

Purpose of review: Cardiovascular disease (CVD) and cancer are the first and second most common causes of death within the USA. It is well established that a diagnosis of cancer increases risk and predisposes the patient to CVD, and vice versa. Despite these associations, cancer is not yet incorporated into current CVD risk calculators, necessitating additional CV risk markers for improved stratification in this at-risk population. In this review, we consider the utility of breast arterial calcification (BAC), coronary artery calcification (CAC), clonal hematopoiesis of indeterminate potential (CHIP), and cancer and cancer treatment in CVD risk assessment.

Recent findings: There is evidence supporting the use of BAC, CAC, CHIP, and cancer and cancer treatment for improved CV risk stratification in patients with cancer and those who are being screened for cancer. BAC has been shown to predict CAC, coronary atherosclerotic plaque on coronary CTA, coronary artery stenosis on coronary angiography, and CVD events and accordingly enhances CVD risk stratification beyond the atherosclerotic CVD (ASCVD) risk pooled cohort equation. Additionally, CAC visualized on CT utilized for lung cancer screening, radiation planning, and cancer staging is predictive of coronary artery disease (CAD). Furthermore, CHIP can also be utilized in risk stratification, as the presence of CHIP carries a 40% increase in CV risk independent of traditional CV risk factors. Finally, cancer and many oncologic therapies confer a lifelong increased risk of CVD. We propose an emerging set of tools to be incorporated into the routine continuum of CVD risk assessment in individuals who have been treated for cancer or who are being screened for cancer development. In this review, we discuss BAC, CAC, CHIP, and cancer and cancer treatment as emerging risk markers in cardiovascular health assessment. Their effectiveness in predicting and influencing the burden of CVD will be discussed, along with suggestions on their incorporation into preventive cardio-oncology practice. Future research will focus on short- and long-term CVD outcomes in these populations.

Type

Article

PubMed ID

35441347