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Objective The survival rate of gynecological cancers (GCs) has improved significantly in recent decades. Patients with GCs did not necessarily succumb to the primary cancer. Cardiovascular health might be a critical determinant of long-term survival. This study aimed to investigate the mortality rate and risk factors associated with cardiovascular disease (CVD) death in patients with GCs. Methods A total of 399,399 cases of GCs diagnosed between 2000 and 2020 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. The standardized mortality ratio (SMR) for CVD mortality was estimated. Prognostic factors for CVD death were assessed using cause-specific hazard ratios with 95% confidence intervals within a competing risk model, considering non-cardiovascular death as a competing risk. Results Of the 399,399 patients with GCs, 117,551 (29%) died from GCs, and 16,371 (4.1%) died from CVD. Of the CVD deaths, 73.2% were attributed to heart disease. The SMR of CVD mortality was highest in survivors diagnosed before age 45 years, and the risk of CVD mortality remained elevated throughout the follow-up period compared to the general United States (US) population. In recent years, the SMRs for CVD mortality risk increased steadily in all subtypes of GCs, except for vulvar cancer. Older age, black race, localized stage, unmarried/single/divorced, vaginal and vulvar cancers, and radiation therapy were associated with a higher risk of CVD mortality. A nomogram was developed and validated using these variables to predict CVD death risk in patients with GCs. Conclusions The risk of CVD mortality in patients with GCs was increased and was significantly higher compared with the general US population. A nomogram was constructed and validated to forecast the risk of CVD mortality in individuals with GCs. More attention should be paid to cardiovascular health during diagnosis to improve survival rates.
Objective The survival rate of gynecological cancers (GCs) has improved significantly in recent decades. Patients with GCs did not necessarily succumb to the primary cancer. Cardiovascular health might be a critical determinant of long-term survival. This study aimed to investigate the mortality rate and risk factors associated with cardiovascular disease (CVD) death in patients with GCs. Methods A total of 399,399 cases of GCs diagnosed between 2000 and 2020 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. The standardized mortality ratio (SMR) for CVD mortality was estimated. Prognostic factors for CVD death were assessed using cause-specific hazard ratios with 95% confidence intervals within a competing risk model, considering non-cardiovascular death as a competing risk. Results Of the 399,399 patients with GCs, 117,551 (29%) died from GCs, and 16,371 (4.1%) died from CVD. Of the CVD deaths, 73.2% were attributed to heart disease. The SMR of CVD mortality was highest in survivors diagnosed before age 45 years, and the risk of CVD mortality remained elevated throughout the follow-up period compared to the general United States (US) population. In recent years, the SMRs for CVD mortality risk increased steadily in all subtypes of GCs, except for vulvar cancer. Older age, black race, localized stage, unmarried/single/divorced, vaginal and vulvar cancers, and radiation therapy were associated with a higher risk of CVD mortality. A nomogram was developed and validated using these variables to predict CVD death risk in patients with GCs. Conclusions The risk of CVD mortality in patients with GCs was increased and was significantly higher compared with the general US population. A nomogram was constructed and validated to forecast the risk of CVD mortality in individuals with GCs. More attention should be paid to cardiovascular health during diagnosis to improve survival rates.
<i>Background: </i>The cardiotoxic effects of anti-tumor therapies represent a critical concern in oncology, as they compromise patient survival and quality of life by inducing cardiovascular diseases. With an increasing number of cancer patients undergoing treatments such as chemotherapy and radiation, the incidence of cardiotoxicity has surged. These adverse effects underscore the necessity of early detection, risk stratification, and preventive strategies tailored to mitigate cardiotoxicity and improve patient outcomes. <i>Objective: </i>This meta-analysis aims to systematically evaluate the effectiveness of various interventions designed to prevent or reduce cardiotoxicity associated with anti-tumor therapies. By synthesizing evidence from existing studies, we seek to identify the most effective measures, providing a comprehensive overview of the current landscape in cardioprotective strategies. <i>Methods: </i>We conducted a comprehensive literature search, including peer-reviewed studies that investigated preventive strategies for cardiotoxicity in patients undergoing anti-tumor therapy. Inclusion criteria were studies evaluating pharmacological and non-pharmacological interventions and their effects on cardiac function and patient outcomes. Data were extracted and analyzed to assess the impact of interventions on cardiotoxicity incidence, cardiac biomarkers, and clinical endpoints. <i>Main Findings: </i>Our analysis demonstrates a range of effective cardioprotective interventions, particularly focusing on beta-blockers, ACE inhibitors, and lifestyle modifications. Beta-blockers were found to reduce the incidence of left ventricular dysfunction, while ACE inhibitors showed promise in improving cardiac biomarkers. Additionally, lifestyle interventions, including exercise and dietary modifications, contributed to overall cardiovascular health, though further research is needed to define optimal protocols. <i>Conclusion: </i>Preventive strategies play a pivotal role in managing cardiotoxicity in cancer patients undergoing anti-tumor therapies. Pharmacological interventions, especially beta-blockers and ACE inhibitors, show significant potential in mitigating cardiac damage, while lifestyle interventions offer supplementary benefits. Our findings underscore the importance of an integrative approach, combining pharmacological and lifestyle modifications to protect cardiac function. Future research should focus on personalized cardioprotective protocols to optimize outcomes for cancer patients, ensuring that cardiovascular health is maintained alongside effective anti-tumor treatment.
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