Abstract
Objectives: To evaluate incident cardiovascular outcomes and imaging phenotypes in UK Biobank participants with previous cancer.
Methods: Cancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls. Competing risk regression was used to calculate sub-distribution hazard ratios (SHRs) for associations of cancer history with incident CVD [ischemic heart disease (IHD), non-ischemic cardiomyopathy (NICM), heart failure (HF), atrial fibrillation/flutter, stroke, pericarditis, venous thromboembolism (VTE)] and mortality outcomes (any CVD, IHD, HF/NICM, stroke, hypertensive disease) over 11.8±1.7years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial (LA) metrics.
Results: We studied 18,714 participants (67% women, age:62 [interquartile range:57-66] years, 97% White ethnicities) with cancer history, including 1,354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVD. Haematological cancer was associated with increased risk of all incident CVDs (SHRs:1.92-3.56), larger chamber volumes, lower ejection fractions, and poorer LV strain. Breast cancer was associated with increased risk of selected CVDs (NICM, HF, pericarditis, VTE; SHRs:1.34-2.03), HF/NICM death, hypertensive disease death, lower LV ejection fraction, and lower LV global function index. Lung cancer was associated with increased risk of pericarditis, HF, and CVD death. Prostate cancer was linked to increased VTE risk.
Conclusions: Cancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.
Methods: Cancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls. Competing risk regression was used to calculate sub-distribution hazard ratios (SHRs) for associations of cancer history with incident CVD [ischemic heart disease (IHD), non-ischemic cardiomyopathy (NICM), heart failure (HF), atrial fibrillation/flutter, stroke, pericarditis, venous thromboembolism (VTE)] and mortality outcomes (any CVD, IHD, HF/NICM, stroke, hypertensive disease) over 11.8±1.7years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial (LA) metrics.
Results: We studied 18,714 participants (67% women, age:62 [interquartile range:57-66] years, 97% White ethnicities) with cancer history, including 1,354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVD. Haematological cancer was associated with increased risk of all incident CVDs (SHRs:1.92-3.56), larger chamber volumes, lower ejection fractions, and poorer LV strain. Breast cancer was associated with increased risk of selected CVDs (NICM, HF, pericarditis, VTE; SHRs:1.34-2.03), HF/NICM death, hypertensive disease death, lower LV ejection fraction, and lower LV global function index. Lung cancer was associated with increased risk of pericarditis, HF, and CVD death. Prostate cancer was linked to increased VTE risk.
Conclusions: Cancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.
| Original language | English |
|---|---|
| Pages (from-to) | 1007-1015 |
| Journal | Heart |
| Volume | 109 |
| Issue number | 13 |
| DOIs | |
| Publication status | Published - 18 Apr 2023 |
Keywords
- Cardio-oncology
- Cardiometabolic disease
- Cardiovascular mortality
- Cardiovascular magnetic resonance
- Epidemiology
Research Beacons, Institutes and Platforms
- Manchester Cancer Research Centre
