SP10.10 Assessment of coronary artery calcification on pre-operative imaging to predict cardiovascular complications in colorectal cancer patients

Abstract

Abstract Background All patients undergoing operative management of colorectal cancer have pre-operative Computer Tomography (CT) imaging of thorax to exclude metastatic disease. Incidental coronary artery calcification is rarely reported on CT. There are a variety of risk scores to predict cardiac complications in the peri-operative period. Current cardiac risk stratification tools do not incorporate radiological evidence of coronary artery calcification in their scoring systems. Methods A retrospective review of 100 patients with confirmed or suspected colorectal cancer. Demographic data was collected. A review of pre-operative CT thorax imaging was completed to ordinal score coronary artery calcification into none, mild, moderate and extensive. Peri-operative and post-operative cardiac and non-cardiac complications were documented. Results Seventy-nine percent of patients had evidence of coronary artery calcification on pre-operative CT thorax. 29 mild, 21 moderate, 29 extensive. Seven percent of patients had a cardiac complication and all of these had coronary artery calcification on CT pre-operatively. Twenty-six had non-cardiac complication and 22 of these had evidence of coronary artery calcification on pre-operative CT. Conclusions There is significant burden of coronary artery calcification in this patient population. This corresponds positively with peri- and post-operative cardiac and non-cardiac complications. Identification pre-operatively can help predict cardiac risk and therefore allow pre-operative cardiac optimisation.