Article Impact Level: HIGH Data Quality: STRONG Summary of Cancer, cncr.35503. https://doi.org/10.1002/cncr.35503 Dr. Jaidyn Muhandiramge et al.
Points
- This study examined the relationship between cancer, its treatment, and cardiovascular disease (CVD) in older adults using data from the ASPREE trial.
- Cancer survivors had a significantly higher rate of CVD events compared to cancer-free participants (20.8 vs. 10.3 events per 1,000 person-years), with an incidence rate ratio of 2.03.
- The elevated CVD risk was consistent across myocardial infarction, heart failure, and stroke and was highest in those with metastatic, hematological, and lung cancers, with chemotherapy increasing the risk further.
- Aspirin use did not significantly reduce CVD incidence in cancer patients, with similar rates of CVD in both aspirin and placebo groups.
- The findings suggest that older adults with cancer, particularly those with advanced disease or undergoing chemotherapy, need alternative strategies to manage cardiovascular risk beyond aspirin use.
Summary
This study aimed to investigate the relationship between cancer, its treatment, and cardiovascular disease (CVD) in older adults, utilizing data from the Aspirin in Reducing Events in the Elderly (ASPREE) trial. The study focused on the incidence of CVD events, including hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke, among participants with and without a cancer diagnosis while also examining the potential role of aspirin in reducing CVD risk in this population.
A total of 15,454 participants from the ASPREE trial were analyzed, with 1,392 individuals diagnosed with cancer during the study period. The results showed that cancer survivors experienced a significantly higher rate of CVD events compared to cancer-free participants (20.8 vs. 10.3 events per 1,000 person-years), with an incidence rate ratio (IRR) of 2.03 (95% CI: 1.51–2.66). This elevated risk was observed across MI, HHF, overall stroke, and ischemic stroke and persisted even after adjusting for traditional CVD risk factors. The highest CVD incidence was seen in those with metastatic, hematological, and lung cancers, with chemotherapy further increasing the risk.
Aspirin use did not significantly reduce CVD incidence in this cohort, with similar rates of CVD observed in both the aspirin and placebo groups. The findings suggest that older adults with cancer, particularly those with advanced disease or undergoing chemotherapy, are at a heightened risk of CVD. The lack of a protective effect from aspirin highlights the need for alternative strategies to manage cardiovascular risk in this vulnerable population.
Link to the article: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.35503
References Muhandiramge, J., Zalcberg, J. R., Warner, E. T., Polekhina, G., Gibbs, P., Van Londen, G. J., Bernstein, W. B., Macrae, F., Haydon, A., Tie, J., Millar, J. L., Mar, V. J., Gately, L., Tonkin, A., Ford, L., Umar, A., Chan, A. T., Woods, R. L., & Orchard, S. G. (2024). Cardiovascular disease and stroke following cancer and cancer treatment in older adults. Cancer, cncr.35503. https://doi.org/10.1002/cncr.35503
