Prevalence and prognosis significance of cardiovascular disease in cancer patients: a population-based study

Liu, Dong; Ma, Zhiqiang; Yang, Jingzhou; Zhao, Min; Ao, Huiping; Zheng, Xiaodong; Wen, Qianfa; Yang, Yuejin; You, Jiangyun; Qiao, Shubin; Yuan, Jiansong

doi:10.18632/aging.102301

Cited by 36 publications

(32 citation statements)

References 35 publications

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“…Besides the abovementioned death reasons, pneumonia and influenza, hypertension as well as atherosclerosis have in the present study been found to be significantly more frequent in older CRC patients in comparison to not only the overall US population but also to the younger aged CRC patient groups. Dong Liu et al reported on the continuous increase of, especially, cardiovascular disease but also hypertension, heart failure, and atrial fibrillation in cancer patients with old age 20 . This adds to the fact that aging itself is a risk factor for cancer development 21,22 .…”

Section: Discussionmentioning

confidence: 99%

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Zhang

et al. 2020

Cancer Medicine

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Background Colorectal cancer (CRC) treatment and patient survival improved greatly. Consequently an increased incidence of non‐cancer‐related deaths is observed. This study analyzed the causes of non‐cancer death for people suffering from CRC based on the year of diagnosis, follow‐up time, and patient's age. Methods The data from patients diagnosed with CRC in the years 2000–2016 were taken from the Surveillance, Epidemiology, and End Results 18 database. Patients were categorized according to: death from CRC, non‐CRC cancer, and non‐cancer. Constituent ratios and standardized mortality ratios (SMRs) were calculated to describe the death causes distribution and relative death risks. Results Between 2000 and 2016, a stable and rapid drop for the original diagnosis as death cause for CRC patients was observed (70.19% to 49.35%). This was coupled to an increase in non‐cancer‐associated death reasons (23.38% to 40.00%). The most common non‐cancer death cause was heart disease, especially for elderly patients. However, deaths from accidents and adverse effects were frequent in younger CRC patients. Patients died from septicemia more often within the first follow‐up year; however, a 6‐fold increase in death from Alzheimer's disease was found for after at least 180 months follow‐up time. The SMRs of all 25 non‐cancer death causes initially decreased in all CRC subgroups, followed by an increase with follow‐up times. Gradually decreasing SMR values were observed with increasing age of CRC patients. Conclusions These findings could help modify and sharpen preventive measures and clinical management and raise physician's awareness to potential non‐CRC death risk factors for CRC patients.

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Section: Discussionmentioning

confidence: 99%

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Zhang

et al. 2020

Cancer Medicine

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“…Therefore, a competing risk model is generally considered more appropriate when patients have other competing risks of death. This is particularly true for patients with lung cancer who are likely to be older and may be afflicted with other pulmonary or cardiac conditions that can represent a serious threat to their overall health [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have primarily focused on the long-term cardiovascular complications of cancer treatments [ 17 , 18 ]. Data related to the prevalence of pre-existing cardiovascular diseases in patients diagnosed with cancer has been reported to range from 5 to 43%, depending on the primary site of malignancy and the geographical region where the study was conducted [ 19 , 20 ]. However, there are limited studies reporting on the impact of pre-existing cardiovascular disease on subsequent treatment patterns and survival outcomes of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Impact of pre-existing cardiovascular disease on treatment patterns and survival outcomes in patients with lung cancer

et al. 2020

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Background Baseline cardiovascular disease (CVD) can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing CVD prior to their diagnosis of lung cancer. Methods We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015 in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between CVD and treatment patterns, and its impact on overall (OS) and cancer-specific survival (CSS), respectively. A competing risk multistate model was developed to determine the excess mortality risk of patients with pre-existing CVD. Results A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70 years. One-third had at least one CVD, with the most common being congestive heart failure in 15% of patients. Pre-existing CVD was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.48–0.58; P < .0001), radiotherapy (OR, 0.76; 95% CI, 0.7–0.82; P < .0001), and surgery (OR, 0.56; 95% CI, 0.44–0.7; P < .0001). Adjusting for measured confounders, the presence of pre-existing CVD predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1–1.2; P < .0001) and CSS (HR, 1.1; 95% CI, 1.1–1.1; P < .0001). However, in the competing risk multistate model that adjusted for baseline characteristics, prior CVD was associated with increased risk of non-cancer related death (HR, 1.48; 95% CI, 1.33–1.64; P < 0.0001) but not cancer related death (HR, 0.98; 95% CI, 0.94–1.03; P = 0.460). Conclusions Patients with lung cancer and pre-existing CVD are less likely to receive any modality of cancer treatment and are at a higher risk of non-cancer related deaths. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management of lung cancer.

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“…This is largely due to the following reasons: i) Cancer and CVDs involve many common risks and pathologic factors, like smoking, diabetes, and aging (1-3); ii) Various cancer treatments cause direct or indirect damage to the cardiovascular system. According to previous investigations, over 60% of patients were prescribed cardiovascular risk drugs during cancer treatments (4,5). Conventional chemotherapy and targeted therapies are associated with an increased risk of cardiac damage including heart failure (HF), hypertension, arrhythmia, thromboembolism, and ischemic cardiomyopathy (CM), and may be life-threatening in some instances.…”

Section: Introductionmentioning

confidence: 99%

New progress in elucidating the relationship between cancer therapy and cardiovascular toxicity

Lin

et al. 2021

BST

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Onco-cardiology is an emerging field linking cancer with cardiovascular injury. Understanding the mechanism of cardiac injury helps improve the quality of life of cancer survivors. A series of studies on adverse reactions to cancer or oncological treatments has indicated that adverse cardiovascular events related to cancer treatments may occur over a longer period of survival, and even years after therapy has concluded. Current cancer therapies, including chemotherapy, radiotherapy, targeted therapy, and immunotherapy, have been found to have latent cardiovascular toxicity. These toxic effects are often progressive and irreversible and ultimately lead to cardiovascular events such as heart failure, hypertension, coronary heart diseases, arrhythmia, and thromboembolism. Therefore, more emphasis should be placed on revealing the mechanism of cancer treatment-related cardiovascular toxicity. This would help to guide prevention, diagnosis, and treatment of CVDs in cancer survivors.

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Prevalence and prognosis significance of cardiovascular disease in cancer patients: a population-based study

Cited by 36 publications

References 35 publications

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Impact of pre-existing cardiovascular disease on treatment patterns and survival outcomes in patients with lung cancer

New progress in elucidating the relationship between cancer therapy and cardiovascular toxicity

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