ArticleAmerican journal of epidemiology2014
Potential increased risk of ischemic heart disease mortality with significant dose fractionation in the Canadian Fluoroscopy Cohort Study.
Article in American journal of epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Biological effects of high-LET irradiation on the circulatory system.International journal of radiation biology · 2025Pooled it
- Ionising radiation and cardiovascular disease: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2023Pooled it
- Radiation and circulatory disease.Mutation research. Reviews in mutation researchPooled it
- Lymphoma and multiple myeloma in cohorts of persons exposed to ionising radiation at a young age.Leukemia · 2021Trial
- Radiation-associated circulatory disease mortality in a pooled analysis of 77,275 patients from the Massachusetts and Canadian tuberculosis fluoroscopy cohorts.Scientific reports · 2017Trial
- Responses of the carotid artery to acute, fractionated or chronic ionizing irradiation, and differences from the aorta.Scientific reports · 2025Article
- Cohort Studies and Multi-omics Approaches to Low-Dose Ionizing Radiation-Induced Cardiovascular Disease: A Comprehensive Review.Cardiovascular toxicology · 2025Review
- A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure.Radiation research · 2024Review
- Revisiting an Inverse Dose-Fractionation Effect of Ionizing Radiation Exposure for Ischemic Heart Disease: Insights from Recent Studies.Radiation research · 2024Review
- Radiotherapy for non-cancer diseases: benefits and long-term risks.International journal of radiation biology · 2024Review
- Radiation exposure and leukaemia risk among cohorts of persons exposed to low and moderate doses of external ionising radiation in childhood.British journal of cancer · 2023Article
- Dose rate effect on mortality from ischemic heart disease in the cohort of Russian Mayak Production Association workers.Scientific reports · 2023Article
- The epidemiology of lung cancer following radiation exposure.International journal of radiation biology · 2023Article
- Article
- Review
- Article
- Fluoroscopy X-Ray Organ-Specific Dosimetry System (FLUXOR) for Estimation of Organ Doses and Their Uncertainties in the Canadian Fluoroscopy Cohort Study.Radiation research · 2021Article
- Estimation of Heights and Body Masses of Tuberculosis Patients in the Canadian Fluoroscopy Cohort Study for Use in Individual Dosimetry.Health physics · 2021Article
- Ionizing radiation-induced circulatory and metabolic diseases.Environment international · 2021Review
- Low- and moderate-dose non-cancer effects of ionizing radiation in directly exposed individuals, especially circulatory and ocular diseases: a review of the epidemiology.International journal of radiation biology · 2021Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Risks of noncancer causes of death, particularly cardiovascular disease, associated with exposures to high-dose ionizing radiation, are well known. Recent studies have reported excess risk in workers who are occupationally exposed to low doses at a low dose rate, but the risks of moderately fractionated exposures, such as occur during diagnostic radiation procedures, remain unclear. The Canadian Fluoroscopy Cohort Study includes 63,707 tuberculosis patients exposed to multiple fluoroscopic procedures in 1930-1952 and followed-up for death from noncancer causes in 1950-1987. We used a Poisson regression to estimate excess relative risk (ERR) per Gy of cumulative radiation dose to the lung (mean dose = 0.79 Gy; range, 0-11.60). The risk of death from noncancer causes was significantly lower in these subjects compared with the Canadian general population (P < 0.001). We estimated small, nonsignificant increases in the risk of death from noncancer causes with dose. We estimated an ERR/Gy of 0.176 (95% confidence interval: 0.011, 0.393) (n = 5,818 deaths) for ischemic heart disease (IHD) after adjustment for dose fractionation. A significant (P = 0.022) inverse dose fractionation effect in dose trends of IHD was observed, with the highest estimate of ERR/Gy for those with the fewest fluoroscopic procedures per year. Radiation-related risks of IHD decreased significantly with increasing time since first exposure and age at first exposure (both P < 0.05). This is the largest study of patients exposed to moderately fractionated low-to-moderate doses of radiation, and it provides additional evidence of increased radiation-associated risks of death from IHD, in particular, significantly increased radiation risks from doses similar to those from diagnostic radiation procedures. The novel finding of a significant inverse dose-fractionation association in IHD mortality requires further investigation.
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