Rates of cardiovascular events are significantly different across cancer types. (14th October 2021)

• Record Type: Journal Article
• Authors: Mitchell, J D M; Laurie, M L; Xia, Q X; Jain, N J; Jain, A J; Lane, D L; Lenihan, D J L
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Cardio-Oncology; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.2877
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: As a result of the effects of both cancer treatment and underlying cardiovascular (CV) risk factors, patients with cancer have a 2 to 6-fold higher CV mortality rate than the general population. Certain cancer types appear to be associated with a greater CV risk, although much of our current understanding is limited to breast and pediatric cancer survivors. We sought to characterize the CV risk factor burden and incidence of CV events across different cancer types. Methods: We included all patients diagnosed with 9 different cancer types (breast, lung, prostate, melanoma, myeloma, kidney, colorectal cancer, leukemia, or lymphoma) after June 1, 2011 in a large US administrative claims database (PharMetrics). Patients had continuous enrollment in the database for ≥12 months prior to cancer diagnosis, and were followed until they had a specified CV event or were disenrolled. Incidence rates for CV events were calculated and Cox proportional hazard multivariable models were used for time-to-event analysis for each cancer type, accounting for baseline CV risk factors. Results: Over 800, 000 patients with cancer were identified across the 9 cancer types. The incidence of CV events was generally >5-fold higher in lung cancer than in breast cancer. The adjusted hazard ratio for the combined CV events of myocardial infarction, stroke, unstable angina, and heart failure was 2.7 (95% confidence interval 2.6–2.7) for lung cancer relative to breast cancer, with a cumulative incidence of 25% by 4 years. Multiple myeloma and leukemia had the next highest cumulative incidence of CV events, while breast cancer and melanoma had the lowest (Table 1 and Figure 1). Conclusion: CV events were significantly increased in certain cancer types, especially lung, multiple myeloma and leukemia, even after accounting for baseline CV risk factors. Patients with lung cancer had a 25% cumulative incidence of combined CV events within 4 years. Understanding the wide variation of CV events in patients with cancer can help inform CV risk factor modification and strategies to minimize CV toxicity, with the aim of reducing the risk of future CV events and improving the morbidity and mortality of cancer survivors. FUNDunding Acknowledgement: Type of funding sources: Private company. Main funding source(s): Bristol Meyers Squibb