2084P - Cardiovascular (CV) mortality among metastatic cancer patients: A retrospective cohort study

Background

CV mortality is the leading preventable cause of death in cancer patients. Understanding the timing and quantifying the magnitude of CV mortality can facilitate strategies to reduce mortality.

Methods

Surveillance, Epidemiology, and End Results (SEER) database (2004-2018) were queried to obtain CV mortality (defined as deaths due to heart diseases, hypertension, cerebrovascular diseases, atherosclerosis, aortic aneurysm, and dissection) in metastatic cancer patients. Standardized mortality ratios (SMRs) were calculated (observed deaths from each category divided by the expected number of deaths in the age-matched US population for the same period). SMR was presented by latency periods of <2, 2-5, and >5 years after the initial diagnosis of metastatic cancer and stratified by age (<50 years, 50-70 years, >70 years), race (White, Black, Asian/Pacific Islander, Native American), and ethnicity (Hispanic, Non-Hispanic).

Results

This analysis included 914,804 metastatic cancer patients. Overall, the risk of CV death was highest <2 years of initial diagnosis (SMR: 2.47, 95% CI: 2.35-2.58) compared to population who died 2-5 years (1.22, 1.17-1.27) and 5>years (1.11, 1.03-1.17) after the initial diagnosis. In terms of different subgroups, younger population (age <50 years) observed the highest risk of CV mortality within < 2 years (8.84, 7.5-10.4) except for prostate cancer, where the risk of cardiovascular death becomes highest at >5 years after diagnosis. Similarly, regarding race, Native Americans had the highest risk of CV mortality (6.44, 4.86-8.54), which remained consistent across different cancers. There was significant increase in observed mortality in Hispanic (2.93, 2.62-3.28) and Non-Hispanic (2.43, 2.31-2.55) population. The mortality risk by ethnicity remained consistent with latency periods of <2, 2-5, and > 5years after the initial diagnosis of metastatic cancer.

Conclusions

Metastatic cancer patients who are younger or those who are Native Americans have the highest CV mortality, especially <2 years of initial diagnosis of metastatic disease. Targeted cardio-oncological strategies should be aimed at improving CV mortality in patients who are at highest risk of deaths.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

I.B. Riaz.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.