Impact of cancer diagnosis on causes and outcomes of 5.9 million US patients with cardiovascular admissions

Matetić, Andrija; Mohamed, Mohamed; Miller, Robert J.H.; Kolman, Louis; Lopez‐Mattei, Juan; Cheung, Winson Y.; Brenner, Darren R.; Spall, Harriette G.C. Van; Graham, Michelle M.; Bianco, Christopher; Mamas, Mamas A.

doi:10.1016/j.ijcard.2021.07.054

Cited by 18 publications

(15 citation statements)

References 42 publications

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“…Previous epidemiologic studies have characterised the rates and utilisation patterns of EDs by patients with cancer [7][8][9][10][11][12][13][14] However, these studies have not specifically looked in granular detail at cardiovascular data. Whilst those that have systematically examined CVD diagnoses have focussed on in-hospital admissions [15] or mortality data. Thus, there is limited data on ED CVD presentations and outcomes amongst cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: a study of 20.6 million records from the USA

Kobo

Moledina

Raisi‐Estabragh

et al. 2022

European Heart Journal

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Background There is limited data on Emergency department (ED) cardiovascular disease (CVD) presentations and outcomes amongst cancer patients. Objectives The present study aimed to describe the clinical characteristics, prevalence, and clinical outcomes of the most common cardiovascular ED admissions in patients with cancer. Methods All ED encounters with a primary CVD diagnosis from the US Nationwide-Emergency Department Sample between January 2016 to December 2018 were stratified by cancer type as well as metastatic status. Multivariable logistic regression was performed to determine the adjusted odds ratios of in-hospital mortality in different groups. Results From a total of 20,737,247 ED encounters with a primary CVD diagnosis, cancer was present in 3.4%. In patients with cancer the most common CVDs were DVT/PE (20%), hypertensive heart or kidney disease (14.7%), and AF/flutter (11.2%). The distribution of CVDs varied by cancer type, with AF/flutter most common in patients with lung cancer, AMI most common in patients with prostate cancer, heart failure most common in those with haematological malignancies, and patients with colorectal cancer having the greatest frequency of DVT/PE. Cancer status was independently associated with significantly higher risk of mortality in almost all CVD categories, consistent across all the cancer types, amongst which lung cancer patients had the highest risk of mortality across all CVD categories, except intracranial haemorrhage and hypertensive crisis. Conclusions Cardiovascular presentations to the ED varied by cancer subtype. Across all cancer subtypes, patients presenting with cardiovascular presentations carried a significantly increased risk of mortality compared to patients with no cancer. Funding Acknowledgement Type of funding sources: None.

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Section: Discussionmentioning

confidence: 99%

Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: a study of 20.6 million records from the USA

Kobo

Moledina

Raisi‐Estabragh

et al. 2022

European Heart Journal

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“…Patients with a history of cancer admitted with a cardiovascular diagnosis are at higher risk of inhospital mortality compared to patients without cancer. 18 Sturgeon et al demonstrated that the contribution of cardiovascular deaths to overall mortality varies significantly across cancer sites. 19 However, details regarding the components of heart disease-related deaths were not available in their study.…”

Section: Comparison With Existing Workmentioning

confidence: 99%

Temporal trends in disease-specific causes of cardiovascular mortality amongst patients with cancer in the USA between 1999 and 2019

Raisi‐Estabragh

Kobo

Freeman

et al. 2022

European Heart Journal - Quality of Care and Clinical Outcomes

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Aims We report disease-specific cardiovascular causes of mortality amongst cancer patients in the USA between 1999 to 2019, considering temporal trends by age, sex, and cancer site. Methods and Results We used the Multiple Cause of Death database, accessed through the CDC WONDER (Centres for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) resource. We included 629,308 decedents with cardiovascular disease (CVD) recorded as the primary cause of death and active malignancy listed as a contributing cause of death. We created disease-specific CVD categories and grouped cancers by site. We calculated the proportion of CVD deaths attributed to each disease category stratified by sex, age, and cancer site. We also examined disease-specific temporal trends by cancer site. Ischaemic heart disease (IHD) was the most common cardiovascular cause of death across all cancer types (55.6%), being more common in men (59.8%), older ages, and in those with lung (67.8%) and prostate (58.3%) cancers. Cerebrovascular disease (12.9%) and hypertensive diseases (7.6%) were other common causes of death. The proportion of deaths due to heart failure was greatest in haematological (7.7%) and breast (6.3%) cancers. There was a decreasing temporal trend in the proportion of cardiovascular deaths attributed to IHD across all cancer types. The proportion of deaths due to hypertensive diseases showed the greatest percentage increase, with largest change in breast cancer patients (+191.1%). Conclusions We demonstrate differential cardiovascular mortality risk by cancer site and demographics, providing insight into the evolving healthcare needs of this growing high cardiovascular risk population.

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“…One of the Nationwide population-based study showed the highest incidence of AF as number per person years in lung cancer: 58.7/1000 in men and 35.3/1000 in women (19). The large analysis of cardiovascular admissions to hospital in US revealed AF as the main cause of hospitalization in lung cancer patients and significantly increased mortality was noted in lung cancer and AF (aOR = 4.69) (20).…”

Section: Cardiac Arrhythmiasmentioning

confidence: 99%

Are cardiovascular comorbidities always associated with a worse prognosis in patients with lung cancer?

Mędrek¹,

Szmit²

2022

Front. Cardiovasc. Med.

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Many factors contribute to mortality in lung cancer, including the presence of concomitant cardiovascular disease. In the treatment of early stage of lung cancer, the presence of comorbidities and occurence of cardiotoxicity may be prognostic. The effect of cardiotoxicity of radiotherapy and chemoradiotherapy on overall survival has been documented. Acute arterial and venous thromboembolic events seem to correlate with the degree of the histological malignancy, its clinical advancement, and even with optimal cardiac treatment, they may influence the survival time. In the case of high-grade and advanced lung cancer stage especially in an unresectable stadium, the prognosis depends primarily on the factors related to the histopathological and molecular diagnosis. Electrocardiographic and echocardiographic abnormalities may be prognostic factors, as they seem to correlate with the patient's performance status as well as tumor localization and size.

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Impact of cancer diagnosis on causes and outcomes of 5.9 million US patients with cardiovascular admissions

Cited by 18 publications

References 42 publications

Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: a study of 20.6 million records from the USA

Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: a study of 20.6 million records from the USA

Temporal trends in disease-specific causes of cardiovascular mortality amongst patients with cancer in the USA between 1999 and 2019

Are cardiovascular comorbidities always associated with a worse prognosis in patients with lung cancer?

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