Cancer Patients At Higher Risk for Heart Disease and Stroke

A new study in the European Heart Journal suggested that patients with cancer are at a higher risk for cardiovascular disease (CVD) than patients without cancer.

“The foundational evidence provided by this investigation is a seminal characterization of 28 cancer sites for CVD mortality risk and provides insight on the scope of CVD mortality risk in cancer patients that has not yet been fully reported,” the researchers wrote. “Future directions include assessing patient risk stratification (sex, race, ethnicity, disease stage, and geographical location). Such an analysis is possible without risking unstable estimates and will improve identification of patients at highest risk for CVD mortality.”

The observational analysis drew upon data collected in the Surveillance, Epidemiology, and End Results Program, which was used to compare the US general population to more than 3.2 million US cancer survivors between 1973 and 2012. The authors then calculated standardized mortality ratios using coded cause of death from CVD (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic dissection/aneurysm).

According to the study results, among 28 different cancer types, there were 1,228, 328 (38%) deaths from cancer and 365,689 (11.3%) deaths from CVD. Of the CVD deaths, 76.3% of them were due to heart disease, according to the authors. CVD mortality was highest in those over 35 years of age, and was highest withing the first year after diagnosis. It remained elevated through follow-up compared with that of the general population. The researchers noted that in patients with endometrial cancer, the first year after diagnosis had a “very high risk of dying from CVD” compared to the chances in the general population.

‘The majority of deaths (absolute numbers) from CVD occur in patients diagnosed with breast, prostate, or bladder cancer,” the researchers wrote in the study. “For patients with cancers of the penis, vulva, bladder, endometrium, prostate, testes, thyroid, or Hodgkin’s lymphoma, there is year-to-year variation in leading cause of death (CV mortality or index-cancer mortality).”

An editorial published with the study suggested that the robust data provided in the analysis contain an important take-away for cardiologists treating cancer patients.

“The important work by Sturgeon et al. confirms that cancer patients have an on average two to six times higher CVD mortality risk than the general population,” the author wrote. “This is a key message that every cardiologist needs to hear.”