{"doi":"10.1002/cam4.70938","title":"Subclinical Atherosclerosis and Cardiovascular Events Among Patients With Colorectal Cancer","abstract":"BACKGROUND: Prior studies have documented that patients with colorectal cancer (CRC) are at an increased risk of cardiovascular disease (CVD). OBJECTIVES: To examine coronary artery calcium (CAC) as a marker of subclinical atherosclerosis and its association with major adverse cardiovascular events (MACE) in patients with CRC across the cancer treatment trajectory. METHODS: Adults with newly diagnosed CRC were enrolled in the prospective ColoCare study from 2017 to 2024. CAC was measured from routine diagnostic computed tomography (CT) and positron emission tomography-CT scans at CRC diagnosis until 5 years post-diagnosis. Atherosclerosis was defined as the presence of CAC. We used multivariable-adjusted Fine and Gray models to assess the association between CAC and MACE risk, accounting for competing risks. RESULTS: Among 300 CRC patients, the most common CVD risk factors at cancer diagnosis were hypertension (37%), hyperlipidemia (24%), and diabetes (14%). During follow-up (median = 5.3 years), 75 (25%) individuals experienced MACE: stroke (3%), new/worsening HF (9%), HF exacerbation requiring hospitalization (2%), coronary revascularization (3%), and death (19%). Among individuals with imaging at baseline (n = 101), 37 (36.6%) had CAC, and statins were not prescribed in 11 (55.0%) patients with moderate/high CAC. For those with serial imaging (n = 61), 31.1% showed worsening CAC and 3% developed new CAC. Baseline CAC conferred a higher risk of MACE (HR = 4.79; 95% CI: 1.05-21.75, p = 0.04) after accounting for cancer-related deaths as a competing risk. CONCLUSIONS: Subclinical atherosclerosis and MACE are common among patients with CRC. Integrating CAC from routine cancer imaging can identify patients who may benefit from cardio-preventive treatment.","journal":"Cancer Medicine","year":2025,"id":541179,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.896,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1429945,"name":"Elham Kazemian","orcid":null,"position":1,"is_corresponding":false},{"id":663913,"name":"Cody Ramin","orcid":"0000-0002-2007-2840","position":2,"is_corresponding":false},{"id":1087524,"name":"Nicole C. 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Byrd","orcid":"0000-0003-4275-7901","position":12,"is_corresponding":false},{"id":376835,"name":"Adetunji T. Toriola","orcid":"0000-0003-1079-2606","position":13,"is_corresponding":false},{"id":348581,"name":"Jennifer Ose","orcid":"0000-0002-2030-9676","position":14,"is_corresponding":false},{"id":218624,"name":"Christopher I. Li","orcid":"0000-0003-1543-0743","position":15,"is_corresponding":false},{"id":519677,"name":"David Shibata","orcid":"0000-0002-5670-423X","position":16,"is_corresponding":false},{"id":85843,"name":"Cornelia M. Ulrich","orcid":"0000-0001-7641-059X","position":17,"is_corresponding":false},{"id":340944,"name":"Balaji Tamarappoo","orcid":null,"position":18,"is_corresponding":false},{"id":1400995,"name":"Katelyn M. Atkins","orcid":"0000-0002-3165-4803","position":19,"is_corresponding":false},{"id":286040,"name":"Jane C. 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