Cardiovascular (CV) disease is common among men with prostate cancer and the leading cause of death in this population. There is a need for CV risk assessment tools that can be easily implemented in the prostate cancer treatment setting. Consecutive patients who underwent positron emission tomography/computed tomography (PET/CT) for recurrent prostate cancer at a single institution from 2012 to 2017 were identified retrospectively. Clinical data and coronary calcification on nongated CT imaging were obtained. The primary outcome was major adverse CV event (MACE; myocardial infarction, coronary or peripheral revascularization, stroke, heart failure hospitalization, or all-cause mortality) occurring within 5 years of PET/CT. Among 354 patients included in the study, there were 98 MACE events that occurred in 74 patients (21%). All-cause mortality was the most common MACE event (35%), followed by coronary revascularization/myocardial infarction (26%) and stroke (19%). Coronary calcification was predictive of MACE (HR = 1.9, 95% CI: 1.1-3.4, = .03) using adjusted Kaplan-Meier analysis. As a comparator, the Framingham risk score was calculated for 198 patients (56%) with complete clinical and laboratory data available. In this subgroup, high baseline Framingham risk (corresponding to 10-year risk of CV disease > 20%) was not predictive of MACE. MACE was common (21%) in men with recurrent prostate cancer undergoing PET/CT over 5 years of follow-up. Incidental coronary calcification on PET/CT was associated with increased risk of MACE and may have utility as a CV risk predictor that is feasible to implement among all prostate cancer providers.

中文翻译：

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接受 PET/CT 成像的前列腺癌男性患者的心血管风险评估中的意外冠状动脉钙化

心血管（CV）疾病在患有前列腺癌的男性中很常见，也是该人群死亡的主要原因。需要可以在前列腺癌治疗环境中轻松实施的心血管风险评估工具。回顾性地确定了 2012 年至 2017 年在同一机构连续接受正电子发射断层扫描/计算机断层扫描 (PET/CT) 治疗复发性前列腺癌的患者。获得了非门控 CT 成像的临床数据和冠状动脉钙化情况。主要结局是 PET/CT 5 年内发生的主要不良心血管事件（MACE；心肌梗塞、冠状动脉或外周血运重建、中风、心力衰竭住院或全因死亡）。在该研究纳入的 354 名患者中，74 名患者 (21%) 发生了 98 起 MACE 事件。全因死亡率是最常见的 MACE 事件 (35%)，其次是冠状动脉血运重建/心肌梗死 (26%) 和卒中 (19%)。使用调整后的 Kaplan-Meier 分析，冠状动脉钙化可预测 MACE（HR = 1.9，95% CI：1.1-3.4，= .03）。作为比较，我们计算了 198 名患者 (56%) 的 Framingham 风险评分，并提供了完整的临床和实验室数据。在该亚组中，高基线 Framingham 风险（相当于 10 年心血管疾病风险 > 20%）并不能预测 MACE。在 5 年随访期间接受 PET/CT 治疗的复发性前列腺癌男性中，MACE 很常见（21%）。 PET/CT 上的偶然冠状动脉钙化与 MACE 风险增加相关，并且可能作为 CV 风险预测指标具有实用性，可在所有前列腺癌提供者中实施。