Calcium supplement.

Looking for an easier way to quantify heart risk after thoracic radiation than by contouring multiple cardiac substructures? This one’s for you. A retrospective analysis of nearly 16,000 women receiving breast irradiation used deep learning algorithms to automatically(!) measure coronary artery calcification on CT sims and then correlate that with incidence of cardiovascular disease obtained from national registries. Indeed, even at a median follow-up of just over 4 years, coronary artery calcium scores were linearly associated with incidence of subsequent cardiovascular disease. Most pronounced were those with the highest calcium scores (3% of the cohort) who had 8x the risk of developing coronary artery disease. Among this population, risk shot up even further among those receiving anthracyclines (HR 5.8) and—now this next one’s particularly noteworthy considering its oftentimes almost negligible absolute benefit—those receiving a radiation boost (HR 6.1). | Gal, JAMA Oncol 2021