A new cancer diagnosis is independently associated with a higher risk of cardiovascular death, according to a large study published in JACC: CardioOncology.
The study also showed an increased risk of stroke, heart failure, and pulmonary embolism among patients with a new cancer diagnosis.
The retrospective study included data from 4,519,243 adults living in Alberta, Canada, from April 2007 to December 2018.
During the study period, there were 224,016 patients with a new cancer diagnosis. The most common types were gynecologic (20%), genitourinary (19%), gastrointestinal (17%), breast (13%), thoracic (10%), and hematologic (9%) cancers.
Researchers compared cardiovascular events in patients with and without a new cancer diagnosis over a median follow-up of 11.8 years. During that time, there were 248,541 deaths, including 73,360 from cardiovascular causes.
In an analysis adjusted for baseline covariates, patients with a cancer diagnosis had an increased risk of:
- Cardiovascular death (hazard ratio [HR], 1.33; 95% CI, 1.29-1.37)
- Stroke (HR, 1.44; 95% CI, 1.41-1.47)
- Heart failure (HR, 1.62; 95% CI, 1.59-1.65)
- Pulmonary embolism (HR, 3.43; 95% CI, 3.37-3.50).
There was no increased risk of myocardial infarction (HR, 1.01; 95% CI, 0.97-1.05).
The excess cardiovascular risk was greatest during the first year after cancer diagnosis but declined over time. However, the risk remained significantly elevated after 10 years of follow-up for cardiovascular mortality, heart failure, and pulmonary embolism.
The highest risk was observed in patients with genitourinary, gastrointestinal, thoracic, nervous system, and hematologic malignancies.
“Our study shows that patients with prior cancer are susceptible to a variety of CV [cardiovascular] events over a long time frame,” the researchers wrote. “Unfortunately, this risk is unlikely to diminish in the short term, given that many newer cancer therapies are also associated with increased risk for myocardial injury and heart failure.”
Paterson DI, Wiebe N, Cheung WY, et al. Incidence cardiovascular disease among adults with cancer. A population-based cohort study. JACC: CardioOncology. 2022;4(1):85-94.