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

2019 ◽  
Vol 40 (48) ◽  
pp. 3889-3897 ◽  
Author(s):  
Kathleen M Sturgeon ◽  
Lei Deng ◽  
Shirley M Bluethmann ◽  
Shouhao Zhou ◽  
Daniel M Trifiletti ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
General Population ◽  
Cancer Diagnosis ◽  
Mortality Risk ◽  
First Year ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality ◽  
Cvd Mortality

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.

scholarly journals Raised cardiovascular disease mortality after central nervous system tumour diagnosis: analysis of 171 926 patients from UK and USA

2021 ◽  
Author(s):  
KAI JIN ◽  
Michael TC Poon ◽  
Paul M Brennan ◽  
Catherine LM Sudlow ◽  
Jonine D Figueroa
Keyword(s):  
Cardiovascular Disease ◽  
Central Nervous System ◽  
Nervous System ◽  
General Population ◽  
Mortality Risk ◽  
Cox Regression ◽  
Malignant Tumours ◽  
Targeted Interventions ◽  
Cns Tumours ◽  
Cvd Mortality

Background Patients with central nervous system (CNS) tumours have significant morbidity and mortality. Some studies showed CNS tumours patients may be at risk for cardiovascular disease (CVD) mortality. The magnitude of CVD risk among CNS tumours patients has not been comprehensively assessed. If CVD mortality is elevated in this population, there may be a potential for risk reduction to improve outcomes. We examined CVD mortality risk in patients with malignant and non-malignant CNS tumours. Methods We conducted analyses using UK (Wales)-based Secure Anonymised Information Linkage (SAIL) for 8743 CNS tumour patients diagnosed in 2000-2015 (54.9% of whom died) and US-based National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) for 163183 patients in 2005-2015 (39.6% of whom died). We calculated age-, sex-, and calendar-year- adjusted standardised mortality ratios (SMRs) for CVD death in CNS tumour patients compared to Welsh and US residents. We used multivariable cause-specific Cox regression models to examine factors associated with CVD mortality among CNS tumour patients. We stratified all analyses by malignancy and main histological types. Results CVD was the second commonest cause of death for CNS tumour patients in SAIL (UK) and SEER (US) (9.5% & 11.7%, respectively). Patients with CNS tumours had higher CVD mortality than the general population (SAIL SMR=2.64, 95% CI=2.39-2.90; SEER SMR=1.38, 95% CI=1.35-1.42). Malignant CNS tumour patients had over 2-fold higher CVD mortality risk in both US and UK cohorts. SMRs for non-malignant tumours were almost 2-fold higher in SAIL than in SEER (SAIL SMR=2.73, 95% CI=2.46-3.02; SEER SMR=1.30, 95% CI=1.26-1.33). The greatest magnitude of excess CVD mortality risk, particularly from cerebrovascular disease, was substantially greater in patients diagnosed at age younger than 50 years and within the first year after their cancer diagnosis (SAIL SMR=2.98, 95% CI=2.39-3.66; SEER SMR=2.14, 95% CI=2.03-2.25). Age, sex, race/ethnicity in USA, deprivation in UK and no surgery were associated with CVD mortality. Discussion CVD mortality is high among patients diagnosed with both malignant and non-malignant CNS tumours compared to the general population. Targeted interventions and risk stratification tools might improve survival.

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