Higher Risks of Stroke, Heart Attack, and Hospital Admission for Heart Failure in Older Cancer Survivors

A recent study published in CANCER, a peer-reviewed journal of the American Cancer Society, has found a significantly higher risk of stroke, heart attack, and hospital admission for heart failure in older cancer survivors compared to those who are cancer-free. The analysis of clinical trial data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, led by Monash University's Suzanne Orchard, PhD, discovered that chemotherapy was associated with a 2-times higher risk of cardiovascular disease events. Additionally, the incidence of cardiovascular disease events was greatest in patients with metastatic, blood, and lung cancers.

Key Takeaways:

• The rate of cardiovascular disease events, including stroke, heart attack, and hospital admission for heart failure, was twice as high in cancer survivors compared to those who were cancer-free, at 20.8 versus 10.3 events per 1,000 person-years.
• Chemotherapy was associated with a 2-times higher risk of cardiovascular disease events.
• The incidence of cardiovascular disease events was greatest in patients with metastatic, blood, and lung cancers.
• Other systemic therapies, such as hormonal therapy, targeted therapy, and radiation therapy, were not conclusively linked to an increased risk of cardiovascular disease events.
• Aspirin, the clinical trial intervention, did not impact cardiovascular disease incidence.
• The study highlights the importance of early screening and preventive measures for cancer survivors to mitigate the risk of cardiovascular disease.

Statistics:

• 15,454 participants in the ASPREE trial, with 1,392 developing cancer over an average follow-up of 4.6 years.
• 20.8 cardiovascular disease events per 1,000 person-years in cancer survivors, compared to 10.3 events in those who were cancer-free.
• 2-times higher risk of cardiovascular disease events associated with chemotherapy.
• 90% of participants developed cancer, with metastatic, blood, and lung cancers having the highest incidence of cardiovascular disease events.

Sources:

• "Cardiovascular disease and stroke following cancer and cancer treatment in older adults." Jaidyn Muhandiramge, John R. Zalcberg, Erica T. Warner, Galina Polekhina, Peter Gibbs, G J. van Londen, Wendy B. Bernstein, Finlay Macrae, Andrew Haydon, Jeanne Tie, Jeremy L. Millar, Victoria J. Mar, Lucy Gately, Andrew Tonkin, Leslie Ford, Asad Umar, Andrew T. Chan, Robyn L. Woods, and Suzanne G. Orchard. CANCER; Published Online: September 23, 2024 (DOI: 10.1002/cncr.35503).
• ASPirin in Reducing Events in the Elderly (ASPREE) trial.
• Monash University's Suzanne Orchard, PhD.