Burden of cardiovascular disease in Japanese cancer patients and survivors: a single cancer-center study in Niigata City
Cardiovascular disease (CVD) and cancer are major causes of death in Japan. As most CVDs are chronic and often aggravate, long-term follow-up is necessary. Although some cancer patients and survivors have CVD, its prognostic significance and prevalence are unknown. Therefore, we conducted a retrospective study at our center to determine the prevalence of cancer patients with CVD.
In 2015, our 10-year (2005–2014) cancer registry was summarized. Comorbidities including left ventricular dysfunction, atrial fibrillation (AF), ischemic heart disease, aortic stenosis, venous thromboembolism (VTE), and elevation of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were examined.
In total, 26,235 de novo cancer patients were registered and 16,130 survived until January 1, 2015. The 5-year survival rate was 64.0% for all cancer patients and 44.2% for cancer patients with CVD. Cox proportional hazards analysis adjusting for age, cancer stage, and body mass index revealed that AF [hazard ratio (HR) 1.219, male; P = 0.038], VTE (HR 1.517, male; P = 0.003 and HR 2.089, female; P < 0.001), and NT-proBNP elevation (HR 1.861, female; P = 0.002) were significantly associated with death. The CVD prevalence among cancer survivors in 2015 was 8.7% vs 3.5% for males vs females. AF was the most common CVD (prevalence: male, 4.0%; female, 1.0%). The prevalence of most CVD in adults increased progressively with age, with male predominance (12.1% for male and 7.5% for female patients in the 80 s age group).
One in 10 elderly cancer survivors has serious CVD. AF, VTE, and heart failure were critical comorbidities. Cardiologists and cancer-care providers should recognize CVD presence and monitor patients closely, providing medications or interventions concurrently with cancer therapy.
KeywordsAtrial fibrillation Venous thromboembolism N-terminal prohormone of brain natriuretic peptide Heart failure
We are indebted to Chika Sekine and Tomomi Fujita (cancer registry) for their superb assistance with the datasets; Sumika Ishigaki, Satoko Sakakibara, Chika Yumoto, Megumi Kira, Keiko Henmi (echocardiography laboratory) for performing electrocardiography, echocardiography, and vascular echo; Naho Sasaki and Masaki Yoshino (Department of Pharmacy) for pharmacological information; Dr. Yoshinobu Okada for treating cancer patients with CVD.
Compliance with ethical standards
Conflict of interest
No author has any conflict of interest.
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