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Burden of cardiovascular disease in Japanese cancer patients and survivors: a single cancer-center study in Niigata City

  • Yuji Okura
  • Tsugumi Takayama
  • Kazuyuki Ozaki
  • Hiroshi Tanaka
  • Hiroshi Seki
  • Tatsuya Takenouchi
  • Nobuaki Sato
  • Tohru Minamino
Original Article

Abstract

Background

Cardiovascular disease (CVD) and cancer are major causes of death in Japan. As most CVDs are chronic and often aggravate, long-term follow-up is necessary. Although some cancer patients and survivors have CVD, its prognostic significance and prevalence are unknown. Therefore, we conducted a retrospective study at our center to determine the prevalence of cancer patients with CVD.

Methods

In 2015, our 10-year (2005–2014) cancer registry was summarized. Comorbidities including left ventricular dysfunction, atrial fibrillation (AF), ischemic heart disease, aortic stenosis, venous thromboembolism (VTE), and elevation of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were examined.

Results

In total, 26,235 de novo cancer patients were registered and 16,130 survived until January 1, 2015. The 5-year survival rate was 64.0% for all cancer patients and 44.2% for cancer patients with CVD. Cox proportional hazards analysis adjusting for age, cancer stage, and body mass index revealed that AF [hazard ratio (HR) 1.219, male; P = 0.038], VTE (HR 1.517, male; P = 0.003 and HR 2.089, female; P < 0.001), and NT-proBNP elevation (HR 1.861, female; P = 0.002) were significantly associated with death. The CVD prevalence among cancer survivors in 2015 was 8.7% vs 3.5% for males vs females. AF was the most common CVD (prevalence: male, 4.0%; female, 1.0%). The prevalence of most CVD in adults increased progressively with age, with male predominance (12.1% for male and 7.5% for female patients in the 80 s age group).

Conclusions

One in 10 elderly cancer survivors has serious CVD. AF, VTE, and heart failure were critical comorbidities. Cardiologists and cancer-care providers should recognize CVD presence and monitor patients closely, providing medications or interventions concurrently with cancer therapy.

Keywords

Atrial fibrillation Venous thromboembolism N-terminal prohormone of brain natriuretic peptide Heart failure 

Notes

Acknowledgements

We are indebted to Chika Sekine and Tomomi Fujita (cancer registry) for their superb assistance with the datasets; Sumika Ishigaki, Satoko Sakakibara, Chika Yumoto, Megumi Kira, Keiko Henmi (echocardiography laboratory) for performing electrocardiography, echocardiography, and vascular echo; Naho Sasaki and Masaki Yoshino (Department of Pharmacy) for pharmacological information; Dr. Yoshinobu Okada for treating cancer patients with CVD.

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Departments of Onco-cardiologyNiigata Cancer Center HospitalNiigataJapan
  2. 2.Departments of Respiratory MedicineNiigata Cancer Center HospitalNiigataJapan
  3. 3.Departments of Diagnostic RadiologyNiigata Cancer Center HospitalNiigataJapan
  4. 4.Departments of DermatologyNiigata Cancer Center HospitalNiigataJapan
  5. 5.Departments of Breast OncologyNiigata Cancer Center HospitalNiigataJapan
  6. 6.Department of Cardiovascular Biology and MedicineNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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