Key result
Incident VTE linked to ~3.2-fold higher mortality risk in ovarian cancer.
Why the study?
Do baseline cardiovascular markers (such as heart rate) and incident cardiovascular comorbidities (such as venous thromboembolism and pulmonary hypertension) reduce overall survival in women with newly-diagnosed epithelial ovarian cancer?
Cohort (n=271)
No
Do baseline cardiovascular markers (such as heart rate) and incident cardiovascular comorbidities (such as venous thromboembolism and pulmonary hypertension) reduce overall survival in women with newly-diagnosed epithelial ovarian cancer?
Elevated baseline heart rate at diagnosis and the post-diagnosis development of venous thromboembolism or pulmonary hypertension are strong independent predictors of reduced survival in women with epithelial ovarian cancer, highlighting the need for integrated cardio-oncology management.
Answers are grounded in this paper and cite their sources.
Supports cardio-oncology monitoring in ovarian cancer; hypothesis-generating for intervention trials.
BACKGROUND: A retrospective cohort study utilizing prospectively collected data was conducted from August 2003 until March 2008 at M.D. Anderson Cancer Center. It is unknown whether cardiovascular comorbidity and chronic stress impact ovarian cancer outcome, which remains poor despite advances in therapy. The purpose of this study was to determine whether cardiovascular disease and markers that may be associated with stress are also associated with survival in patients with ovarian cancer. METHODS: Participants with newly diagnosed epithelial ovarian cancer were followed until time of death or truncation of study period (median follow-up = 4.2 years; n = 271). Tumor characteristics (stage, tumor grade, histology, debulking status), demographic variables, and cardiovascular comorbidity were documented and compared to overall survival. RESULTS: Of the nine cardiovascular events tracked during follow-up, venous thromboembolism [VTE; HR, 3.2; 95% confidence interval (CI), 1.8-5.5] and pulmonary hypertension (HR, 8.5; 95% CI, 3.9-18.7) were associated with shorter survival in multivariate analysis. In addition, high tumor grade, suboptimal cytoreduction, and baseline heart rate (HR, 1.02; 95% CI, 1.01-1.04) were related to decreased survival. CONCLUSION: Careful management of certain cardiovascular comorbidities may extend survival in patients with ovarian cancer. Our findings suggest that increased baseline heart rate and the development of VTE and pulmonary hypertension after cancer diagnosis may be significant predictors of survival in women with ovarian cancer. IMPACT: Our study emphasizes the importance of identifying and optimally treating tachycardia, VTE, and pulmonary hypertension in conjunction with cancer therapy.
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Shinn et al. (2013) conducted a cohort in Newly-diagnosed epithelial ovarian cancer (n=271). Cardiovascular comorbidities and incident events (specifically pulmonary hypertension, venous thromboembolism, and baseline heart rate) vs. Absence of respective cardiovascular comorbidity or lower baseline heart rate was evaluated on Overall survival (time to death) associated with incident venous thromboembolism (VTE) (HR 3.2, 95% CI 1.8-5.5, p=<0.05). Venous thromboembolism, pulmonary hypertension, and higher baseline heart rate were independently associated with shorter survival in ovarian cancer patients.
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