A population-based study of cardiovascular disease mortality risk in US cancer patients

Abstract

Aims This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. Methods and results The Surveillance, Epidemiology, and End Results program was used to compare the US general population to 3 234 256 US cancer survivors (1973–2012). Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic aneurysm/dissection). Analyses were adjusted by age, race, and sex. Among 28 cancer types, 1 228 328 patients (38.0%) died from cancer and 365 689 patients (11.3%) died from CVDs. Among CVDs, 76.3% of deaths were due to heart disease. In eight cancer sites, CVD mortality risk surpassed index-cancer mortality risk in at least one calendar year. Cardiovascular disease mortality risk was highest in survivors diagnosed at <35 years of age. Further, CVD mortality risk is highest (SMR 3.93, 95% confidence interval 3.89–3.97) within the first year after cancer diagnosis, and CVD mortality risk remains elevated throughout follow-up compared to the general population. Conclusion The majority of deaths from CVD occur in patients diagnosed with breast, prostate, or bladder cancer. We observed that from the point of cancer diagnosis forward into survivorship cancer patients (all sites) are at elevated risk of dying from CVDs compared to the general US population. In endometrial cancer, the first year after diagnosis poses a very high risk of dying from CVDs, supporting early involvement of cardiologists in such patients.

Cause‐specific mortality in individuals with lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia, 2000–2016

“…In contrast to infections, cardiovascular and neurological diseases – the other most common non‐cancer deaths in patients with LPL/WM (Castillo et al , ) – posed no overall increased risk of mortality compared to the general population. The borderline but not significantly elevated mortality risk (SMR 1·1) from cardiovascular diseases after LPL/WM contrasts with strikingly increased cardiovascular mortality risks among patients with other NHLs and solid cancers (Abuamsha et al , ; Sturgeon et al , ), possibly reflecting lower use of cardiotoxic agents and radiotherapy in LPL/WM. Decreased risks of neurological deaths may be due to under‐reporting of dementia as an underlying cause of death (Macera et al , ; Ganguli & Rodriguez, ; Ives et al , ; Romero et al , ), although the novel finding of elevated risk of death due to cerebrovascular diseases exclusively in patients aged <65 years at LPL/WM diagnosis correlates with the higher observed rates of symptomatic hyperviscosity among younger patients with WM (Bustoros et al , ).…”

Increased risk of cardiovascular death in breast cancer patients without chemotherapy or (and) radiotherapy: a large population-based study.

“…Although cardiovascular comorbidities of the research subjects could not be taken into account in this study, the compared general population also included those with or without cardiovascular comorbidities. The comparison performed by using SMR analysis, which is widely used in similar studies, (9,11,15) may balance out the effect of pre-existing cardiovascular comorbidities. Moreover, the majority of the subjects accepted surgery, which indicated that they had less possibility of having serious cardiovascular comorbidities.…”

“…In this registry-based cohort study, the data of breast cancer patients were obtained from the SEER-18 database, an authoritative program providing 18 cancer registries data and covering approximately 34.6 percent of the American population (http://seer.cancer.gov/). The SEER database has been frequently used for cardio-oncology studies (9,10,14,15). To compare with the cohort derived from the SEER database, the referred standardized population cohort was retrieved from Wide-ranging Online Data for Epidemiologic Research of the Centers for Disease Control and Prevention (CDC WONDER).…”

“…Previous studies indicate that CVD risk might also be higher among breast cancer patients not exposed to CT or RT. A recent study revealed that breast cancer survivors suffered elevated CVD risk (9). Furthermore, a population-based study also showed that CVD risk of breast cancer survivors was apparently higher than that of the general population (10).…”

Carfilzomib Induced Cardiotoxicity in a Multiple Myeloma Patient

“…Comparing the cardiovascular mortality rate in patients with MM (less than 10%) versus the mortality generated by cancer itself and its associated complications (overall 5-year survival rate of 54%), it can be challenging balancing the potential heart dysfunction caused by this chemotherapeutic agent with its positive effects in the treatment of MM patients. (15) (16). For this reason it is extremely important to offer interdisciplinary management with the cardio-oncology team, explore the patient preferences and discuss which treatment options best ts the patient needs (17).…”