Key result
Cancer history linked to higher incident CVD and adverse remodeling, particularly for haematological and breast cancers.
Why the study?
To evaluate incident cardiovascular outcomes and cardiac imaging phenotypes in UK Biobank participants with a history of cancer.
Does a history of cancer increase the risk of incident cardiovascular events and adverse cardiac remodeling compared to non-cancer controls?
Cohort (n=18,714)
Does a history of cancer increase the risk of incident cardiovascular events and adverse cardiac remodeling compared to non-cancer controls?
A history of cancer, particularly haematological and breast cancer, is associated with an increased risk of incident cardiovascular disease and adverse cardiac remodeling independent of traditional vascular risk factors.
Cancer survivors may face higher CVD risk; leaves open tailored surveillance or prevention before changing practice.
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 subdistribution HRs (SHRs) for associations of cancer history with incident CVD (ischaemic heart disease (IHD), non-ischaemic 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±1.7 years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial metrics. RESULTS: We studied 18 714 participants (67% women, age: 62 (IQR: 57-66) years, 97% white ethnicities) with cancer history, including 1354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVDs. Haematological cancer was associated with increased risk of all incident CVDs considered (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 and 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.
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Raisi‐Estabragh et al. (2023) conducted a cohort in Previous cancer (n=18,714). History of cancer vs. Non-cancer controls was evaluated on Incident cardiovascular disease and mortality outcomes. A history of cancer, particularly haematological (SHRs 1.92-3.56) and breast cancer (SHRs 1.34-2.03), was associated with an increased risk of incident cardiovascular diseases and adverse cardiac remodelling.
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