Respir Med. 2026 May 4:108869. doi: 10.1016/j.rmed.2026.108869. Online ahead of print.
ABSTRACT
BACKGROUND: Coronary artery disease and lung cancer share common risk factors, which may increase the risk of cardiovascular events in patients with lung cancer. Coronary artery calcification (CAC) and vascular inflammation can be evaluated through chest computed tomography (CT) and 18F-FDG-PET/CT, respectively. This study aimed to evaluate the relationship between CAC or vascular inflammation and cardiovascular events in patients with non-small cell lung cancer (NSCLC).
METHODS AND RESULTS: We studied 119 patients with NSCLC who underwent both chest CT and 18F-FDG-PET/CT. CAC score was measured using chest CT. Vascular inflammation was assessed using 18F-FDG-PET/CT, with the maximum target-to-background ratio (TBRmax) measured at 8 major arteries. Cardiovascular events, including all-cause death, acute coronary syndrome, unplanned coronary revascularization for angina pectoris, and stroke, were compared between groups with high and low TBRmax and high (≥100) and low (<100) CAC scores. Cardiovascular event-free survival tended to be lower in high CAC score than low CAC score group (Log rank, P=0.105). Among patients with early-stage lung cancer (stage 0-II), cardiovascular event-free survival was similar between the two groups. However, in patients with advanced lung cancer (stage III or IV), cardiovascular event-free survival was significantly lower in high CAC score than low CAC score group (Log rank, P=0.029). On the other hand, there were no significant differences in cardiovascular event-free survival between high and low TBRmax groups.
CONCLUSION: Coronary artery calcification may be associated with cardiovascular events and mortality in patients with advanced-stage NSCLC, whereas vascular inflammation was not associated with outcomes in this cohort.
PMID:42092596 | DOI:10.1016/j.rmed.2026.108869