Huazhen Yang1,2,3, Yu Zeng1,2, Wenwen Chen1,2, Yajing Sun1,2, Yao Hu1,2, Zhiye Ying1,2, Junren Wang1,2, Yuanyuan Qu1,2, Fang Fang4, Unnur A Valdimarsdóttir5,6,7, Huan Song8,9,10. 1. West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. 2. Med-X Center for Informatics, Sichuan University, Chengdu, China. 3. Mental Health Center, West China Hospital of Sichuan University, Chengdu, China. 4. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 5. Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. 6. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 8. West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. songhuan@wchscu.cn. 9. Med-X Center for Informatics, Sichuan University, Chengdu, China. songhuan@wchscu.cn. 10. Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. songhuan@wchscu.cn.
Abstract
BACKGROUND: Evidence is scarce regarding the potential modifying role of disease susceptibility on the association between a prior cancer diagnosis and cardiovascular disease (CVD). METHODS: We conducted a matched cohort study of UK Biobank including 78,860 individuals with a cancer diagnosis between January 1997 and January 2020, and 394,300 birth year and sex individually matched unexposed individuals. We used Cox model to assess the subsequent relative risk of CVD, which was further stratified by individual genetic predisposition. RESULTS: During nearly 23 years of follow-up, an elevated risk of CVD was constantly observed among cancer patients, compared to their matched unexposed individuals. Such excess risk was most pronounced (hazard ratio [HR] = 5.28, 95% confidence interval [CI] 4.90-5.69) within 3 months after a cancer diagnosis, which then decreased rapidly and stabilised for >6 months (HR = 1.22, 95% CI 1.19-1.24). For all the studied time periods, stratification analyses by both levels of polygenic risk score for CVD and by family history of CVD revealed higher estimates among individuals with lower genetic risk predisposition. CONCLUSIONS: Our findings suggest that patients with a recent cancer diagnosis were at an increased risk of multiple types of CVD and the excess CVD risk was higher among individuals with lower genetic susceptibility to CVD, highlighting a general need for enhanced psychological assistance and clinical surveillance of CVD among newly diagnosed cancer patients.
BACKGROUND: Evidence is scarce regarding the potential modifying role of disease susceptibility on the association between a prior cancer diagnosis and cardiovascular disease (CVD). METHODS: We conducted a matched cohort study of UK Biobank including 78,860 individuals with a cancer diagnosis between January 1997 and January 2020, and 394,300 birth year and sex individually matched unexposed individuals. We used Cox model to assess the subsequent relative risk of CVD, which was further stratified by individual genetic predisposition. RESULTS: During nearly 23 years of follow-up, an elevated risk of CVD was constantly observed among cancer patients, compared to their matched unexposed individuals. Such excess risk was most pronounced (hazard ratio [HR] = 5.28, 95% confidence interval [CI] 4.90-5.69) within 3 months after a cancer diagnosis, which then decreased rapidly and stabilised for >6 months (HR = 1.22, 95% CI 1.19-1.24). For all the studied time periods, stratification analyses by both levels of polygenic risk score for CVD and by family history of CVD revealed higher estimates among individuals with lower genetic risk predisposition. CONCLUSIONS: Our findings suggest that patients with a recent cancer diagnosis were at an increased risk of multiple types of CVD and the excess CVD risk was higher among individuals with lower genetic susceptibility to CVD, highlighting a general need for enhanced psychological assistance and clinical surveillance of CVD among newly diagnosed cancer patients.
Authors: Kathleen M Sturgeon; Lei Deng; Shirley M Bluethmann; Shouhao Zhou; Daniel M Trifiletti; Changchuan Jiang; Scott P Kelly; Nicholas G Zaorsky Journal: Eur Heart J Date: 2019-12-21 Impact factor: 29.983
Authors: Hannah T Jordan; Sara A Miller-Archie; James E Cone; Alfredo Morabia; Steven D Stellman Journal: Prev Med Date: 2011-10-28 Impact factor: 4.018
Authors: Viola Vaccarino; Jack Goldberg; Cherie Rooks; Amit J Shah; Emir Veledar; Tracy L Faber; John R Votaw; Christopher W Forsberg; J Douglas Bremner Journal: J Am Coll Cardiol Date: 2013-06-27 Impact factor: 24.094
Authors: Huan Song; Fang Fang; Filip K Arnberg; David Mataix-Cols; Lorena Fernández de la Cruz; Catarina Almqvist; Katja Fall; Paul Lichtenstein; Gudmundur Thorgeirsson; Unnur A Valdimarsdóttir Journal: BMJ Date: 2019-04-10
Authors: Helen Strongman; Sarah Gadd; Anthony Matthews; Kathryn E Mansfield; Susannah Stanway; Alexander R Lyon; Isabel Dos-Santos-Silva; Liam Smeeth; Krishnan Bhaskaran Journal: Lancet Date: 2019-08-20 Impact factor: 202.731