Mohamed M Gad1, Anas M Saad2, Muneer J Al-Husseini3, Abdelrahman Ibrahim Abushouk4, Sami Salahia4, Karim Abdur Rehman5, Haris Riaz5, Haitham M Ahmed6. 1. Cleveland Clinic, OH, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: gadm2@ccf.org. 2. Cleveland Clinic, OH, USA; Faculty of Medicine, Ain Shams University, Cairo, Egypt. 3. Ascension St. John, MI, USA. 4. Faculty of Medicine, Ain Shams University, Cairo, Egypt. 5. Cleveland Clinic, OH, USA. 6. AdvantageCare Physicians, New York, NY, USA.
Abstract
BACKGROUND: We evaluated the risk of cardiac death in patients with prior cancer diagnoses and compared risk by cancer type and ethnicity in a large US population. METHOD: Utilizing the Surveillance, Epidemiology, and End Results database, data on patients with a cancer diagnosis between 2000 and 2014 were obtained. We calculated the standardized mortality ratio (SMR) of cardiac death after a cancer diagnosis and the excess risk per 10,000 person-years. We stratified the analysis according to the time interval between cancer and cardiac events, cancer site, cancer stage, and race. RESULTS: A total of 4,671,989 patients with a cancer diagnosis were included, of which 163,255 died due to cardiac causes within 10 years of diagnosis. We found a significantly higher rate of cardiac death for cancer patients [SMR=1.16, 95% confidence interval (CI) 1.15-1.16] compared to the general population. When observed for each cancer site, the highest SMR was after a diagnosis of hepatocellular carcinoma (SMR=2.58, 95% CI 2.45-2.72), pancreatic cancer (SMR=2.36, 95% CI 2.25-2.47), and lung cancer (SMR=2.30, 95% CI 2.27-2.34). Patients with metastatic disease had a higher rate of cardiac death (SMR=2.16, 95% CI 2.13-2.19). When stratified by ethnicity, SMR for cardiac death was 1.76, 2.28, 3.68, 2.65, and 1.84 for whites, blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics, respectively. CONCLUSIONS: Cancer patients are more vulnerable to cardiac death than the general population, especially those with nonwhite ethnicity; liver, lung, and pancreatic cancers; and history of metastasis. Healthcare providers should be aware of this risk and pay particular attention to the highest-risk groups.
BACKGROUND: We evaluated the risk of cardiac death in patients with prior cancer diagnoses and compared risk by cancer type and ethnicity in a large US population. METHOD: Utilizing the Surveillance, Epidemiology, and End Results database, data on patients with a cancer diagnosis between 2000 and 2014 were obtained. We calculated the standardized mortality ratio (SMR) of cardiac death after a cancer diagnosis and the excess risk per 10,000 person-years. We stratified the analysis according to the time interval between cancer and cardiac events, cancer site, cancer stage, and race. RESULTS: A total of 4,671,989 patients with a cancer diagnosis were included, of which 163,255 died due to cardiac causes within 10 years of diagnosis. We found a significantly higher rate of cardiac death for cancerpatients [SMR=1.16, 95% confidence interval (CI) 1.15-1.16] compared to the general population. When observed for each cancer site, the highest SMR was after a diagnosis of hepatocellular carcinoma (SMR=2.58, 95% CI 2.45-2.72), pancreatic cancer (SMR=2.36, 95% CI 2.25-2.47), and lung cancer (SMR=2.30, 95% CI 2.27-2.34). Patients with metastatic disease had a higher rate of cardiac death (SMR=2.16, 95% CI 2.13-2.19). When stratified by ethnicity, SMR for cardiac death was 1.76, 2.28, 3.68, 2.65, and 1.84 for whites, blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics, respectively. CONCLUSIONS:Cancerpatients are more vulnerable to cardiac death than the general population, especially those with nonwhite ethnicity; liver, lung, and pancreatic cancers; and history of metastasis. Healthcare providers should be aware of this risk and pay particular attention to the highest-risk groups.
Authors: Mohamed M Gad; Mihnea-Alexandru Găman; Anas M Saad; Muneer J Al-Husseini; Omar A Shehata; Mohannad Abou Saleh; Alfred D Nelson; Carlos Roberto Simons-Linares Journal: Ann Gastroenterol Date: 2020-02-12
Authors: Ahmed O Elmehrath; Ahmed M Afifi; Muneer J Al-Husseini; Anas M Saad; Nathaniel Wilson; Kyrillus S Shohdy; Patrick Pilie; Mohamad Bassam Sonbol; Omar Alhalabi Journal: JAMA Netw Open Date: 2021-08-02