Cardiovascular disease burden in adult patients with cancer: An 11-year nationwide population-based cohort study
Authors
Jong-Chan Youn ; Woo-Baek Chung ; Justin A Ezekowitz ; Jung Hwa Hong ; Hyewon Nam ; Dae-Sung Kyoung ; In-Cheol Kim ; Alexander R Lyon ; Seok-Min Kang ; Hae Ok Jung ; Kiyuk Chang ; Yong-Seog Oh ; Ho-Joong Youn ; Sang Hong Baek ; Hyeon Chang Kim
Citation
INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.317 : 167-173, 2020-10
Cancer ; Cardiovascular disease burden ; Mortality ; Population-based cohort
Abstract
Background: Cardiovascular disease (CVD) is an important cause of morbidity and mortality in patients with cancer. However, the real-world CVD burden of adult cancer patients has not been well established. This study aimed to evaluate the prevalence and mortality of pre-existing and new-onset CVD in patients with cancers.
Methods: We analysed the prevalence and mortality of pre-existing and new-onset CVD in 41,034 adult patients with ten common solid cancers in a single payer system using data from the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013.
Results: When all types of cancer were included, 11.3% (n = 4647) of patients had pre-existing CVD when they were diagnosed with cancer. After excluding patients with pre-existing CVD, 15.7% of cancer patients (n = 5703) were newly diagnosed with CVD during the follow-up period (median 68 months). Both pre-existing and new-onset CVD were associated with increased risk of overall mortality and 5-year mortality. Multivariate analysis to predict all-cause mortality indicated both pre-existing and new-onset CVD, male sex, old age, prior history of diabetes or chronic kidney disease, suburban residential area, and low-income status as significant factors.
Conclusions: Eleven percent of cancer patients had pre-existing CVD at the time of cancer diagnosis, and about 16% of cancer patients without pre-existing CVD were newly diagnosed with CVD, mostly within 5 years after the cancer diagnosis. Proper management of pre-existing CVD is necessary and pre-emptive prevention of new-onset CVD may alter treatment options and outcomes.