TY - JOUR
T1 - Cardiovascular disease and stroke following cancer and cancer treatment in older adults
AU - Muhandiramge, Jaidyn
AU - Zalcberg, John R.
AU - Warner, Erica T.
AU - Polekhina, Galina
AU - Gibbs, Peter
AU - van Londen, G. J.
AU - Bernstein, Wendy B.
AU - Macrae, Finlay
AU - Haydon, Andrew
AU - Tie, Jeanne
AU - Millar, Jeremy L.
AU - Mar, Victoria J.
AU - Gately, Lucy
AU - Tonkin, Andrew
AU - Ford, Leslie
AU - Umar, Asad
AU - Chan, Andrew T.
AU - Woods, Robyn L.
AU - Orchard, Suzanne G.
N1 - Publisher Copyright:
© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
PY - 2024
Y1 - 2024
N2 - Background: Cancer survivors can be at risk of cardiovascular disease (CVD) because of either their malignancy or its treatment. Although studies linking cancer and CVD exist, few examine risk in older adults, the impact of cancer treatment, or the effect of aspirin on reducing risk in this cohort. Methods: The authors conducted a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial to investigate the impact of cancer and cancer treatment on a composite CVD end point comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke. Results: Of 15,454 Australian and US ASPREE participants, 1392 had an incident cancer diagnosis. Rates of CVD were greater in the cancer risk-set compared to the cancer-free risk-set (20.8 vs. 10.3 events per 1000 person-years; incidence rate ratio, 2.03; 95% confidence interval, 1.51–2.66), with increased incidence seen across MI, HHF, overall stroke, and ischemic stroke. Increased incidence remained after adjustment for clinically significant risk factors for CVD. Incidence was greatest in metastatic, hematological, and lung cancer. Chemotherapy was associated with increased risk of CVD. Similar rates of CVD were seen across aspirin and placebo groups. Conclusions: Incidence of CVD, including MI, HHF, and ischemic stroke, was increased in older adults with cancer. Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.
AB - Background: Cancer survivors can be at risk of cardiovascular disease (CVD) because of either their malignancy or its treatment. Although studies linking cancer and CVD exist, few examine risk in older adults, the impact of cancer treatment, or the effect of aspirin on reducing risk in this cohort. Methods: The authors conducted a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial to investigate the impact of cancer and cancer treatment on a composite CVD end point comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke. Results: Of 15,454 Australian and US ASPREE participants, 1392 had an incident cancer diagnosis. Rates of CVD were greater in the cancer risk-set compared to the cancer-free risk-set (20.8 vs. 10.3 events per 1000 person-years; incidence rate ratio, 2.03; 95% confidence interval, 1.51–2.66), with increased incidence seen across MI, HHF, overall stroke, and ischemic stroke. Increased incidence remained after adjustment for clinically significant risk factors for CVD. Incidence was greatest in metastatic, hematological, and lung cancer. Chemotherapy was associated with increased risk of CVD. Similar rates of CVD were seen across aspirin and placebo groups. Conclusions: Incidence of CVD, including MI, HHF, and ischemic stroke, was increased in older adults with cancer. Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.
KW - cancer
KW - cardiovascular disease
KW - elderly
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85204467902&partnerID=8YFLogxK
U2 - 10.1002/cncr.35503
DO - 10.1002/cncr.35503
M3 - Article
AN - SCOPUS:85204467902
SN - 0008-543X
JO - Cancer
JF - Cancer
ER -