24 September 2026
Cancer survivors already face a higher risk of heart disease than the general population. Now, Baker Heart and Diabetes Institute researchers have found another piece of the puzzle: survivors carry significantly more high-risk plaque in their coronary arteries, the type most likely to rupture and trigger a heart attack.
The study, published in the European Heart Journal Cardio-Oncology, compared cardiac CT scans from 97 long-term cancer survivors (largely relating to breast and blood cancers) and 365 people without cancer who had a similar risk profile. All participants had early-stage coronary plaque and none were taking statins, so the researchers could focus on this key difference alone.
Using specialised software to measure plaque volume and type, they found survivors had 10% more total plaque in their coronary arteries. More strikingly, they had 45% more of the high-risk kind linked to future heart attacks, surprising even the research group.
First author, Dr Cheng Soh says the findings strengthen the case for moving from simply being aware of the heart risk for cancer survivors to acting on it.
"Our previous studies have shown cancer survivors face nearly double the risk of cardiovascular disease," Dr Soh says. "This study adds to that picture by showing survivors also carry a greater volume of high-risk plaque. It tells us we need to be more proactive with heart risk assessment and management in this group.
Colleagues like Dr Joshua Wong are already putting this into practice, building integrated cardio-oncology programs at centres including the Peter MacCallum Cancer Centre in Melbourne, so that as cancer survival improves, patients aren't left facing preventable heart problems down the track.
The next challenge is working out who needs closer monitoring. Screening every cancer survivor with a CT coronary angiogram isn't realistic from a cost perspective, so the team's focus now turns to identifying which survivors are most at risk. By identifying these people early enough, action can be taken before a heart attack happens.
