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Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer

Mamas, Mamas A

Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer Thumbnail


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Abstract

Objectives: To evaluate incident cardiovascular outcomes and imaging phenotypes in UK Biobank participants with previous cancer. Methods: Cancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls. Competing risk regression was used to calculate subdistribution HRs (SHRs) for associations of cancer history with incident CVD (ischaemic heart disease (IHD), non-ischaemic cardiomyopathy (NICM), heart failure (HF), atrial fibrillation/flutter, stroke, pericarditis, venous thromboembolism (VTE)) and mortality outcomes (any CVD, IHD, HF/NICM, stroke, hypertensive disease) over 11.8±1.7 years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial metrics. Results: We studied 18 714 participants (67% women, age: 62 (IQR: 57–66) years, 97% white ethnicities) with cancer history, including 1354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVDs. Haematological cancer was associated with increased risk of all incident CVDs considered (SHRs: 1.92–3.56), larger chamber volumes, lower ejection fractions, and poorer LV strain. Breast cancer was associated with increased risk of selected CVDs (NICM, HF, pericarditis and VTE; SHRs: 1.34–2.03), HF/NICM death, hypertensive disease death, lower LV ejection fraction, and lower LV global function index. Lung cancer was associated with increased risk of pericarditis, HF, and CVD death. Prostate cancer was linked to increased VTE risk. Conclusions: Cancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.

Citation

Mamas, M. A., Raisi-Estabragh, Z., Cooper, J., McCracken, C., Crosbie, E. J., Walter, F. M., …Petersen, S. E. (2023). Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer. Heart, heartjnl-2022-321888. https://doi.org/10.1136/heartjnl-2022-321888

Journal Article Type Article
Acceptance Date Dec 28, 2022
Online Publication Date Mar 22, 2023
Publication Date Mar 1, 2023
Publicly Available Date May 30, 2023
Journal Heart
Print ISSN 1355-6037
Electronic ISSN 1468-201X
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Pages heartjnl-2022-321888
DOI https://doi.org/10.1136/heartjnl-2022-321888
Keywords magnetic resonance imaging, epidemiology
Publisher URL https://heart.bmj.com/content/early/2023/03/21/heartjnl-2022-321888

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