A new cancer diagnosis may be independently associated with a "significantly higher risk" for cardiovascular death, stroke, heart failure, and pulmonary embolism, especially in the first year, according to a study published March 15 in JACC: CardioOncology.

Ian Paterson, MD, et al., used administrative health care databases to conduct a population-based retrospective cohort study of more than 4,500,000 adult cancer patients residing in Alberta, Canada. The median follow-up was nearly 12 years. The study compared newly diagnosed cancer patients vs. participants without cancer to determine the risk of subsequent cardiovascular events – including death, myocardial infarction, stroke, heart failure and pulmonary embolism. The researchers created a time-to-event survival model adjusted for sociodemographic data and comorbidities.

The authors found that a new cancer diagnosis was "associated with an increased risk for fatal and nonfatal cardiovascular events, even after adjustment for baseline risk." In addition, regardless of cancer site, patients were at increased risk for cardiovascular mortality, heart failure, stroke, or pulmonary embolism, especially in the first year, and the risk persisted after 10 years of follow-up for heart failure and pulmonary embolism. Of note, cardiovascular risk was highest for patients with genitourinary, gastrointestinal, thoracic, nervous system and hematologic malignancies.

"These findings highlight the need for a collaborative approach to health care for patients with cancer and cancer survivors," Paterson et al., conclude. They add that moving forward, "future studies should evaluate other potential contributors to cardiovascular risk, including cancer therapies and emerging risk factors of cardiotoxicity."

In a related editorial comment, Hiroshi Ohtsu, MS, et al., explain, "Although the clinical implications of the findings are important, some additional steps are needed before these can be translated into clinical practice." They conclude that, "perhaps the lesson we need to learn ... is that it is time for cardiology and oncology to collaborate in order to travel upstream and build a powerhouse to generate information from the new flow of data efficiently."

Clinical Topics: Cardio-Oncology, Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Vascular Medicine, Acute Heart Failure

Keywords: Cardiovascular Diseases, Follow-Up Studies, Retrospective Studies, Cancer Survivors, Cardiotoxicity, Risk Factors, Heart Failure, Myocardial Infarction, Stroke, Pulmonary Embolism, Hematologic Neoplasms, Heart Disease Risk Factors, Delivery of Health Care, Cardiology, Neoplasms, Cardio-oncology

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