Increased Risk of Cardiovascular Death in Breast Cancer Patients Without Chemotherapy or (and) Radiotherapy: A Large Population-Based Study

Abstract

BackgroundCardiovascular death (CVD) in breast cancer patients without chemotherapy (CT) or (and) radiotherapy (RT) has not been studied yet. This study evaluates the correlation between breast cancer and CVD risk independent of chemotherapy or (and) radiotherapy.MethodsData of female breast cancer patients without receiving CT or RT were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004–2015). Data were divided into two cohorts: tumor resection cohort and no resection cohort. The CVD risk in patients was expressed as standardized mortality ratios (SMRs). A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and competing risk regressions were utilized to evaluate the impact of tumor resection on CVD.ResultsThe CVD risk was significantly higher (SMR = 2.196, 95% CI: 2.148–2.245, P<0.001) in breast cancer patients who did not receive CT or RT compared to the general population. Breast cancer patients without tumor resection showed higher CVD risk than patients who underwent tumour resection (tumor resection SMR = 2.031, 95% CI: 1.983–2.079, P<0.001; no resection SMR = 5.425, 95% CI: 5.087–5.781, P<0.001). After PSM, the CVD risk among patients without tumor resection indicated an increase of 1.165-fold compared to patients with tumor resection (HR=1.165, 95% CI: 1.039–1.306, P=0.009).ConclusionsFemale breast cancer patients are at higher risk of CVD despite unexposure to cardio-toxic CT or RT. However, female breast cancer patients subjected to tumor resection have decreased CVD risk. These results indicated that monitoring female breast cancer patients not receiving RT or CT might serve as a preventative measure against CVD.

Association Between Radiotherapy and Death From Cardiovascular Disease Among Patients With Cancer: A Large Population‐Based Cohort Study

“…Furthermore, Guan et al reported that the tumor itself, not just the cardiotoxicity of radiotherapy, might increase the incidence of CVD deaths in patients who did not undergo radiotherapy. 20 , 31 Given these findings, the limitations of the present study led to the misconception that radiotherapy reduced CVD deaths in patients with breast, thyroid, and colorectal cancers.…”

“… 14 , 15 , 16 , 17 , 18 However, some previous studies have also reported that the incidence of CVD deaths among patients with cancer is not elevated. 19 , 20 , 21 Hence, a unified conclusion on the relationship between radiotherapy and CVD deaths in patients with solid tumors has not yet been reached. In addition, knowledge of the tumors that increase the incidence of CVD deaths after radiotherapy is particularly important.…”

Metabolic Syndrome and Risk of Cardiovascular Diseases in Female Breast Cancer Survivors

“…22 According to cardio-oncologists, cardiotoxic therapies (including chemotherapy or radiotherapy) are the main contributors to an increase in CVD risk in BCS. 23 In a case-control study with 2168 women from Northern Europe with breast adenocarcinoma treated with radiotherapy, 24 each 7 Gy of radiation corresponded to an increase in cardiovascular risk of 7.4%. The risk was observed 5 years after receiving radiotherapy and persisted for 30 years.…”

Association of Digoxin Application Approaches With Long-Term Clinical Outcomes in Rheumatic Heart Disease Patients With Heart Failure: A Retrospective Study

“…The 1:1 propensity score matching (PSM) and statistical analyses were executed by SPSS version 24 (SPSS, Chicago, IL). The 1:1 PSM was executed referring to our previous methods ( 16 ) by baseline characteristics at enrollment such as age at diagnosis, age of surgery, disease duration, follow-up time, levels of systolic/diastolic blood pressure (SBP/DBP) and heart rate (Hr), surgical intervention, cardiac valve damage, NYHA, medical condition, combined medication, blood test index, and echocardiographic index. The caliper width was 0.1 for PSM.…”