title: Cancer and Its Association With the Development of Coronary Artery Calcification: An Assessment From the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Although cancer and its corresponding therapies are associated with increased ischemic heart disease, the temporal relationship between cancer and the development of coronary artery calcium (CAC), a marker of subclinical atherosclerosis, is unknown.
  
  
  RESULTS
  Among 3122 men and women free of cardiovascular disease and cancer in the Multi-Ethnic Study of Atherosclerosis trial, CAC scoring was performed at baseline (2000-2002) and at follow-up (2010-2012). Over this 10-year period, 85 men (age 63.6±8.3 years) and 50 women (age 62.1±9.8 years) were diagnosed with cancer (predominantly breast, lung, or uterine [52%] in women and prostate or colorectal [78%] in men). The other 2987 subjects (age 59.6±9.2 years for men, 59.7±9.4 years for women) remained cancer free. The incidence of new CAC (baseline Agatston score of zero converting to detectable CAC) was modeled with relative risk regression and compared for cancer versus no cancer. Increase in pre-existing CAC was compared in these groups using linear regression of log transformed CAC. The incidence of CAC was independently associated with cancer history (relative risk 1.32 [P=0.04] and 1.29 [P=0.01] for women and men, respectively). In participants with CAC at baseline, a clear difference of CAC progression was not observed between cancer and noncancer participants (P=0.6 for women, P=0.2 for men).
  
  
  CONCLUSIONS
  A diagnosis of cancer is associated with the development of CAC even after accounting for atherosclerotic risk factors. However, in individuals with pre-existing CAC, it is not clear whether the presence of cancer accelerates CAC over time.
authors.affiliation: Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (M.C.W., J.Y., G.H.).
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Whitlock
authors.affiliation: Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (M.C.W., J.Y., G.H.).
authors.forename: Joseph
authors.initials: J
authors.lastname: Yeboah
authors.affiliation: Department of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (G.L.B.).
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston Salem, NC (H.C.).
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.affiliation: Section on Hematology-Oncology, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (H.D.K.).
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
authors.affiliation: Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (M.C.W., J.Y., G.H.) Department of Radiological Sciences, Wake Forest School of Medicine, Winston Salem, NC (G.H.).
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States; D061205:Vascular Calcification / Q000175:diagnosis / Q000453:epidemiology*
keywords: cancer; cardiotoxicity; coronary artery calcium; subclinical atherosclerosis risk factor