The aging population is increasing in developed countries, including the United States, Canada and Australia as well as European countries, and the increase is even greater in Japan [1–3]. Although prolonged life expectancy is one of the biggest achievements of humankind, expansion of the oldest population also implies a rise in age-related diseases, including malignancies and cardiovascular disorders . Among malignant diseases in the aging population, lung cancer is the leading cause of death in Japan and worldwide [4–6]. Patients with lung cancer have a poor prognosis, with only 15% of them being eligible for surgical resection [4, 6]. Although the therapeutic response is limited, patients with advanced disease are usually treated with systemic chemotherapy or tyrosine inhibitors [4, 6].
In Japan, surgery is not usually indicated as a therapeutic option for the oldest group of lung cancer patients (older than 80years of age) because of poor performance status [7, 8]. Because the performance status of some elderly groups with lung cancer has dramatically improved, aging is no longer an exclusion criterion for surgical intervention. However, the presence of concomitant diseases, such as emphysema, high blood arterial hypertension, coronary ischemic disease, cerebrovascular disorders and diabetes mellitus, are not uncommon in the elderly. Therefore, a meticulous presurgical examination is critical to avoiding complications during and after surgery [9–11]. In particular, the risk of complications is much higher in the elderly people with coronary disease associated with diabetes mellitus or the metabolic syndrome .
In the present study, we evaluated the usefulness of three-dimensional computed tomographicangiography (3D-CTA) for the detection of coronary disease in the elderly before surgical intervention for lung cancer.