According to a population-based study published yesterday, cancer significantly increases the risk of patients with cardiovascular morbidity and mortality, regardless of the type of cancer, especially within the first year of diagnosis.
A retrospective analysis containing data from more than 200,000 cancer patients found that the new cancer diagnosis significantly increased the risk of cardiovascular (CV) death (hazard ratio). [HR]1.33) and other CV events (including) stroke (HR, 1.44), heart failure (HR, 1.62) and Pulmonary embolus (HR, 3.43).
From the results, the researchers conclude that “diagnosis of new cancers is independently associated with a significant increase in the risk of cardiovascular death and non-fatal morbidity, regardless of the location of the cancer.” rice field.
The Survey results Published online on March 15th Journal of the American College of Cardiology: CardioOncology..
Cancer patients and cancer survivors are known to be at increased risk of heart failure, but the evidence for the risk of other CV outcomes is less clear.In addition, the authors state that many cancer treatments, including chest irradiation and chemotherapy, may increase the risk of developing cardiovascular disease during and after treatment, but long-term data. CV risk Conflicts among cancer survivors.
D. Ian Paterson, MD and co-author of the University of Alberta in Edmonton, Canada, co-authored how new cancer diagnoses at different sites and stages affect the risk of long-term fatal and non-fatal CV events. I wanted to clarify.
The current analysis included data from 224,016 patients diagnosed with new cancers identified from a management database of more than 4.5 million adults living in Alberta, Canada. Researchers identified 73,360 CV deaths and 470,481 non-fatal CV events between April 2007 and December 2018.
Comparing CV events in patients with and without cancer, we found that after adjusting for socio-population data and comorbidities (hazard ratios), the risk of CV mortality in cancer patients was 33% in a 12-year study follow-up. I found that it increased. [HR], 1.33; 95% CI, 1.29 – 1.37). Cancer patients were also at increased risk of stroke (HR, 1.44), heart failure (HR, 1.62), and pulmonary embolism (HR, 3.43), but they were not. Myocardial infarction (HR, 1.01; 95% CI, 0.97 – 1.05), compared to people without cancer.
The degree of risk depends slightly on the stage of the cancer, the time elapsed since it was diagnosed, and the type of cancer.
The diagnosis of the new cancer significantly increased the risk of CV mortality, heart failure, stroke, or pulmonary embolism in patients regardless of the cancer site, but the risk of CV events is urogenital, gastrointestinal, chest, The highest in patients with the nervous system, and hematological malignancies. These patients accounted for more than half of the cancer cohort and more than 70% of the incident CV burden.
Patients with more advanced cancer had the highest risk of poor CV outcomes, but even patients with very early-stage disease faced an increased risk.
The risk of CV events was greatest in the first year after cancer diagnosis for all outcomes (HR, 1.24-8.36), but remained significantly increased in CV death, heart failure, and pulmonary embolism 10 years later. was.
Overall, the authors conclude that in the long run, “cancer patients make up a high-risk population of CV disease,” and cancer patients “jointly include cardiologists, stroke and thrombosis specialists.” You may benefit from management. “
Accompanying editorial, Dr. Hiroshi Otsu of Juntendo University in Tokyo, and colleagues conclude that this study has important clinical significance as “having amazing strengths.” However, Otsu et al. Argue that additional steps may be required before these findings can be reflected in clinical practice.
For example, this study is limited by its retrospective population-based design and lack of data on cancer treatment and some patient factors such as ethnicity, smoking, and physical activity.
The authors of the study agree that future studies need to assess how cancer treatment and other potential causes of CV outcomes affect patient risk.
“Such studies may lead to better predictions of CV risk in cancer patients and survivors and improved prevention and treatment strategies,” they write.
This study was supported by a Foundation grant from the Canadian Institute of Health to Toneri. The author does not disclose the relevant financial relationship. This editing was partially supported by funding for individual authors from the Japan Society for the Promotion of Science / Ministry of Education, Culture, Sports, Science and Technology, Ministry of Health, Labor and Welfare, and the Medical Research and Development Agency. ..
J Am CollCardiol Cardio Onc. Published online on March 15, 2022. Full text, editorial
Sharon Worcester is an award-winning medical journalist at MDedge News, part of the Medscape Professional Network.
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