Regardless of Site, Newly Diagnosed Cancer Patients Are At Risk of CV Mortality

Patients with cancer and cancer survivors are at increased risk for incident heart failure, but there are conflicting data on the long-term risk for other cardiovascular events and how such risk may vary by cancer site. To further explore, Dr D. Ian Paterson and his team conducted a study to determine the impact of a new cancer diagnosis on the risk for fatal and nonfatal cardiovascular events.

Using administrative health care databases, the researchers conducted a population-based retrospective cohort study among 4,519,243 adults residing in Alberta, Canada, from April 2007 to December 2018. They compared the patients with new cancer diagnoses during the study period with those without cancer with respect to risk for subsequent cardiovascular events (cardiovascular mortality, myocardial infarction, stroke, heart failure, and pulmonary embolism) using time-to-event survival models after adjusting for sociodemographic data and comorbidities.

Key findings of the study:

• The researchers observed 73,360 cardiovascular deaths and 470,481 nonfatal cardiovascular events during a median follow-up period of 11.8 years.
• After adjustment, they found that the patients with cancer had HRs of 1.33 for cardiovascular mortality, 1.01 for myocardial infarction, 1.44 for stroke, 1.62 for heart failure, and 3.43 for pulmonary embolism, compared with participants without cancer.
• They highlighted that the cardiovascular risk was highest for patients with genitourinary, gastrointestinal, thoracic, nervous system and hematologic malignancies.

The authors concluded, "A new cancer diagnosis is independently associated with a significantly increased risk for cardiovascular death and nonfatal morbidity regardless of the cancer site. These findings highlight the need for a collaborative approach to health care for patients with cancer and cancer survivors."

They further added, " Future studies should evaluate other potential contributors to CV risk, including cancer therapies and emerging risk factors of cardiotoxicity."

In an accompanying editorial, Dr Hiroshi Ohtsu and his team concluded that the work "has remarkable strengths" and important clinical implications. They wrote, "Cardiology and oncology need to collaborate to launch and successfully execute projects to establish new techniques to use real-world data for real-world evidence".

For further information:

DOI: https://www.jacc.org/doi/10.1016/j.jaccao.2022.01.100

Keywords:

real-world data, real-world evidence, CV risk, cardiovascular mortality, Cancer, newly diagnosed cancer, administrative health care databases, Malignancy, JACC: CardioOncology, Ian Paterson