CN38 - Risk of cardiovascular mortality among cancer survivors in the United States: The role of inflammation

Background

Cardiovascular disease (CVD) mortality among cancer survivors is increasing with advances in cancer screening and treatment modalities. However, most studies have been conducted only in cancer cohorts, and evidence is limited regarding the risk of CVD mortality among cancer survivors compared with healthy populations, with possible mechanisms remaining unclear. This study aimed to comprehensively assess the risk of CVD mortality among cancer survivors compared to the healthy population and to explore the role of chronic low-grade inflammation in this process.

Methods

The study population was drawn from participants in the 2001-2014 National Health and Nutrition Examination Survey (NHANES). Cancer diagnosis was determined based on self-reported disease history, and mortality outcome was determined by the NHANES-linked National Death Index. The Fine and Gray competing risk model was conducted to assess the association between cancer and CVD mortality, and the association between the chronic low-grade inflammation (as assessed by the Chronic Low-Grade Inflammation Score) and CVD mortality among cancer survivors.

Results

The final study population consisted of 2803 cancer survivors and 25,376 healthy participants. With a median follow-up of 83 months, 141(3.14%) and 516 (1.27%) CVD deaths occurred in cancer survivors and healthy population, respectively. There was a higher risk of CVD death in cancer survivors than in the healthy population [HR (95% CI): 1.320 (1.085-1.605)], especially in breast cancer survivors [HR (95% CI): 2.036 (1.233-3.362)], independently of the common risk factors of cancer and CVD. Cancer survivors with the highest quartile of chronic low-grade inflammation levels suffered from an increased risk of CVD mortality compared to those with the lowest quartile [HR (95% CI): 2.337 (1.218-4.484)].

Conclusions

Cancer survivors, particularly breast cancer survivors, suffer an increased risk of CVD mortality compared with healthy populations, and chronic low-grade inflammation may be involved in this process. Further studies are needed to explore the impact of specific cancer treatments on CVD and the underlying mechanisms, so as to further improve the survival and quality of life of cancer survivors.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.