Cardiovascular risk assessment in patients with differentiated thyroid cancer undergoing radioiodine therapy.

Autor: Stanciu, Adina Elena, Bolovan, Lucica Mădălina, Frăsineanu, Camelia, Stanciu, Marcel Marian, Verzia, Andreea, Tegus, Tincuţa, Nicorovici, Claudia, Dragomir, Daniela, Dumitrescu, Aurelia, Zamfirescu, Anca
Předmět:
Zdroj: Oncolog-Hematolog; 2021, Issue 55, p47-47, 1p
Abstrakt: Objective. In the last decade, an increasing number of studies have estimated the cardiovascular risk in different populations, mainly using the Framingham risk score (FRS) and Systematic COronary Risk Evaluation (SCORE). The accuracy of these risk scores for predicting cardiovascular events in differentiated thyroid cancer (DTC) is not well established, despite a high prevalence of hypertension, dyslipidemia and cardiovascular disease among DTC patients. The current study aimed at comparing the FRS and SCORE models in predicting cardiovascular events in patients with DTC undergoing radioiodine (131I) therapy. Methodology. Thirty­three patients with DTC (mean age 55.9 ± 10.7 years old) and eight patients with DTC associated with type 2 diabetes mellitus (DTC+T2DM) (mean age 65 ± 9.8 years old) were included in the study. FRS and SCORE questionnaires incorporated risk factors such as age, sex, total cholesterol, high­density lipoprotein cholesterol, systolic blood pressure, and smoking status. Cardiac function was assessed by echocardiography. Results. DTC+T2DM patients had a higher cardiovascular risk than that calculated in DTC patients without T2DM according to FRS and SCORE tools (11.4±9.7 versus 10.7±9.5, p=0.27, and 4.9±2.7 versus 2.3±1.8, p=0.02, respectively). Of the two cardiovascular risk assessment models, only SCORE was associated with the left ventricle ejection fraction (LVEF) in the DTC+T2DM group (r=­0.75, p=0.03). The high cumulative activity of 131I was independently correlated with LVEF in patients with DTC without T2DM (r=­0.49; p<0.01). Conclusions. Our results indicate that DTC patients have an increased cardiovascular risk. This risk can be estimated by using the SCORE model in patients with coexisting T2DM. The mechanisms that mediate cardiovascular risk in these patients seem to involve the systemic chronic inflammation characteristic of T2DM. In patients with DTC without T2DM exposed to high cumulative radiation doses of 131I, the cardiovascular risk assessment tool should contain the total activity of 131I administered per patient. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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