Risk of cardiovascular disease among Nordic childhood cancer survivors with diabetes mellitus: A report from adult life after childhood cancer in Scandinavia

Winther, Jeanette Falck; Bhatia, Smita; Cederkvist, Luise; Guðmundsdóttir, Þorgerður; Madanat‐Harjuoja, Laura; Tryggvadóttír, Laufey; Wesenberg, Finn; Hasle, Henrik; Holmqvist, Anna Sällfors

doi:10.1002/cncr.31696

Cited by 16 publications

(7 citation statements)

References 32 publications

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“…Exposure to cytotoxic agents and radiation have rendered childhood cancer survivors at an increased risk of developing cardiovascular disease, metabolic syndrome, diabetes, hypertension and other conditions as a result of long-term vascular complications. [36][37][38][39] In this study, we have shown that clinical biomarkers of CVD are significantly elevated in young adult survivors of childhood leukemia.…”

Section: Discussionmentioning

confidence: 68%

Retinal Vessel Analysis as a Novel Screening Tool to Identify Childhood Acute Lymphoblastic Leukemia Survivors at Risk of Cardiovascular Disease

Azanan

Chandrasekaran

Rosli

et al. 2020

Journal of Pediatric Hematology/Oncology

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Azanan: Research investigation, data analysis and curation, data interpretation, manuscript writing, editing, data visualization, manuscript review and review and approval of final manuscript. Sudhashini Chandrasekaran: Research investigation, data analysis and curation, data interpretation, manuscript review and review and approval of final manuscript. Erda Syerena Rosli: Research investigation, manuscript review and review and approval of final manuscript. Chua Ling Ling: Research investigation, manuscript review and review and approval of final manuscript. Oh Lixian: Research investigation, manuscript review and review and approval of final manuscript. Chin Tong Foh: Research investigation, manuscript review and review and approval of final manuscript.

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Section: Discussionmentioning

confidence: 68%

Retinal Vessel Analysis as a Novel Screening Tool to Identify Childhood Acute Lymphoblastic Leukemia Survivors at Risk of Cardiovascular Disease

Azanan

Chandrasekaran

Rosli

et al. 2020

Journal of Pediatric Hematology/Oncology

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“…Moreover, cancer survival should be considered an independent CV risk factor [ 103 ]. A proinflammatory and hypercoagulable condition with increased platelet activation and aggregability typically occurs in cancer, increasing the prevalence of ACS [ 72 , 104 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It

Lucà

Parrini²,

Abrignani

et al. 2022

JCM

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Cancer patients have an increased risk of cardiovascular disease and, notably, a significant prevalence of acute coronary syndrome (ACS). It has been shown that an elevated presence of cardiovascular risk factors in this setting leads to an interaction between these two conditions, influencing their therapeutic strategies and contributing to higher mortality. Nonetheless, cancer patients have generally not been evaluated in ACS trials, so that the treatment in these cases is still not fully known. We reviewed the current literature and discussed the best management for these very high-risk patients. The treatment strategy must be tailored based on the cancer type and stage, balancing thrombotic and bleeding risks. When the prognosis is longer than six months, especially if a clinical instability coexists, patients with ACS and cancer should be referred for percutaneous coronary intervention (PCI) as soon as possible. Moreover, an invasive strategy should be preferred in STEMI patients as well as in NSTEMI patients who are considered as high risk. On the contrary, in clinically stable NSTEMI patients, a conservative non-invasive strategy could be adopted, especially in cases of a poor life expectancy and/or of high risk of bleeding. Drug-Eluting-Stents (DES) should be the first choice if an invasive strategy is adopted. Conservative therapy could instead be considered in cancer patients with more stable CAD at an increased risk of major bleeding complications. However, the duration of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is recommended, but it should be as short as possible, whereas triple antithrombotic therapy is non-advised because it significantly increases the risk of bleeding. ACS management among cancer patients should be based on an accurate evaluation of the risk of thrombosis and bleeding. Future studies focused on choosing optimal strategies in tumor patients with ACS should be performed to treat this subset of patients better.

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“…Over the past few decades, the number of children surviving brain tumors has reached record rates. However, survivors are at risk of developing obesity, cardiovascular disease, and type 2 diabetes mellitus 9 , 10 , 27 – 32 . While childhood obesity and dysglycemia drive early adult mortality 33 , SCBT have higher rates of adverse cardiometabolic outcomes and premature mortality than the general population but with similar BMI-defined obesity rates 9 , 10 , 16 , 27 – 32 , 34 .…”

Section: Discussionmentioning

confidence: 99%

High molecular weight adiponectin levels are inversely associated with adiposity in pediatric brain tumor survivors

Ronsley

Rassekh

Fleming

et al. 2020

Sci Rep

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While children with brain tumors are surviving at record rates, survivors are at risk of cardiovascular disease and type 2 diabetes mellitus; these conditions may be driven by excess body fat. Adiponectin in an adipokine that is inversely associated with the fat mass, and has been linked to cardiometabolic risk stratification in the general population. However, adiponectin’s profile and determinants in SCBT have not been established. We tested the hypothesis that high molecular weight (HMW) adiponectin levels, the more biologically active form of adiponectin, were associated with adiposity in SCBT similarly to non-cancer controls. Seventy-four SCBT (n = 32 female) and 126 controls (n = 59 female) who were 5–17 years old were included. Partial correlations and multivariable regression analyses assessed the relationship between HMW adiponectin and adiposity. HMW adiponectin was inversely associated with total and central adiposity (FM%: β − 0.21, 95% CI − 0.15, − 0.08; p value < 0.0001; WHR: β − 0.14, 95% CI − 0.02, − 0.01; p value < 0.0001 ;WHtR: β − 0.21, 95% CI − 0.05, − 0.03; p value < 0.0001). In conclusion, HMW adiponectin is inversely correlated with adiposity in SCBT. Adiponectin may serve as a biomarker of cardiometabolic risk and response to interventions to prevent and manage obesity and its comorbidities in SCBT.

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Risk of cardiovascular disease among Nordic childhood cancer survivors with diabetes mellitus: A report from adult life after childhood cancer in Scandinavia

Cited by 16 publications

References 32 publications

Retinal Vessel Analysis as a Novel Screening Tool to Identify Childhood Acute Lymphoblastic Leukemia Survivors at Risk of Cardiovascular Disease

Retinal Vessel Analysis as a Novel Screening Tool to Identify Childhood Acute Lymphoblastic Leukemia Survivors at Risk of Cardiovascular Disease

Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It

High molecular weight adiponectin levels are inversely associated with adiposity in pediatric brain tumor survivors

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