Patients with abdominal aortic aneurysm had similar 15-year cancer incidence compared to coronary artery disease patients (30% vs 28%, p=0.60) but worse overall survival (HR 1.54; 95% CI 1.22-1.94).
Cohort (n=690)
No
Does having an abdominal aortic aneurysm compared to coronary artery disease increase the long-term incidence of cancer and reduce overall survival?
Patients with abdominal aortic aneurysm have a higher long-term risk of incident cancer and lower overall survival compared to patients with coronary artery disease, highlighting the potential need for enhanced cancer screening in this population.
Absolute Event Rate: 30% vs 28%
p-value: p=0.60
AbstractBackground Recent studies have highlighted the importance of cancer screening in patients with cardiovascular diseases (CVDs) and the high incidence of malignancy in these patient populations. The aim was to determine cancer incidence and overall survival (OS) in patients with abdominal aortic aneurysm (AAA) compared to patients with coronary artery disease (CAD). Methods AAA (n=151) and CAD (n=539) patients admitted to the university hospital of Liège (Belgium) between 2009 and 2011 were followed up until December 2023. Diagnosis was confirmed by CT-scan for AAA patients and by coronarography for CAD patients. Patients with cancer or with a history of cancer, as well as CAD patients affected by AAA, were excluded. Demographic variables and CVD risk factors were collected at baseline. During follow-up, cases of cancer and of death were recorded along with surgeries. Study outcomes were cumulative incidence rate of cancer and OS assessed by Cox and competing risk models. Results At baseline, AAA and CAD cohorts differed significantly for several demographic and clinical characteristics. At 15 years follow-up, no difference in cancer incidence rate was observed between AAA and CAD patients (30% vs. 28% p=0.60). A higher risk of cancer was detected among AAA patients as compared to CAD patients beyond 7 years of follow-up (HR=1.87, 95%CI: 1.09−3.20, p=0.023). Female sex and aspirin use were identified as protective factors for cancer, regardless of the group. Although cancer-free survival was comparable in the two groups (p=0.097), OS differed between AAA and CAD groups (HR=1.54, 95%CI: 1.22−1.94, p=0.0002). In the adjusted mortality risk analysis, age, smoking status, diabetes, chronic obstructive pulmonary disease, renal insufficiency, peripheral artery disease, and CRP values ≥ 6 mg/l were associated with poor survival. Conclusions Long-term risk of cancer was higher in AAA patients than in CAD patients and OS lower. In both groups, aspirin use and female sex were protective factors for cancer development but not for mortality. Differences in cancer type distribution were also observed, suggesting distinct risk profiles that warrant close monitoring.
Sakalihasan et al. (Fri,) conducted a cohort in Abdominal aortic aneurysm and coronary artery disease (n=690). Abdominal aortic aneurysm vs. Coronary artery disease was evaluated on Cumulative incidence rate of cancer (p=0.60). Patients with abdominal aortic aneurysm had similar 15-year cancer incidence compared to coronary artery disease patients (30% vs 28%, p=0.60) but worse overall survival (HR 1.54; 95% CI 1.22-1.94).