Cardiovascular Mortality among Patients with Pancreatic Cancer: A Population-based Study

Abstract

Background With the advancements in detection and treatment, the survival rates of patients with pancreatic cancer have gradually increased. However, cardiovascular disease has become a common complication among tumor patients due to treatments. The mortality and risks of cardiovascular mortality in patients with pancreatic cancer remain unclear. Objectives This retrospective cohort study aimed to evaluate the mortality patterns and quantify cardiovascular mortality risk in patients with pancreatic cancer. Methods Data extracted from the US Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018 were used to conduct this study. Patients aged 15 or older with a primary diagnosis of pancreatic cancer were included. The primary endpoint was the death of cardiovascular disease among pancreatic cancer patients. Standardized mortality ratios (SMRs) were compared with the general cancer population in the US. The Competing Risk model was used to assess the association between pancreatic cancer and cardiovascular disease. Results A total of 125,324 patients primarily diagnosed with pancreatic cancer were enrolled, with a median follow-up time of 4.0 (1.0–12.0) months. The mean age at diagnosis was 68.97 ± 12.88 years, and 62,271 (49.69%) were male. Overall, 2862 patients died of cardiovascular disease. The SMR of cardiovascular disease was 1.81 (1.74–1.88), and the highest SMR in the subtype of cardiovascular disease was atherosclerosis (2.69, 95%CI: 1.90–3.48). In the multivariable Competing Risk model, patients with older age at diagnosis and who underwent surgery were associated with higher risks of cardiovascular diseases. Conclusions Cardiovascular disease mortality among patients with pancreatic cancer is higher than that in the general cancer population in the US. Patients with pancreatic cancer at higher risk of cardiovascular disease need more attention.