With the large and growing population of cancer survivors over the last several decades, there exists significant concern that these patients may be at an increased risk of cardiovascular disease. However, few studies have examined risks of multiple specific outcomes of cardiovascular disease in survivors of a wide range of cancers. In this population-based cohort study, 108,215 cancer survivors of the 20 most common cancers, alive 12 months after diagnosis, and 523,541 matched controls were studied to compare the risks of a range of long-term cardiovascular disease outcomes. Primary care, hospital, and cancer registry data were obtained through the UK Clinical Practice Research Datalink. At 10 years after cancer diagnosis, 15.2% of cancer survivors and 19.0% of controls were still under follow-up. At baseline, smoking, hypertension, previous history of cardiovascular disease, and chronic kidney disease were slightly more prevalent in cancer survivors than matched controls, whereas heavy drinking was slightly less prevalent in cancer survivors than matched controls at baseline. Researchers found that cancer survivors were at an increased risk of venous thromboembolism (in 18 of 20 cancers), heart failure or cardiomyopathy (10 of 20 cancers), arrhythmia (8 of 20 cancers), pericarditis (8 of 15 cancers), coronary artery disease (5 of 20 cancers), stroke (5 of 20 cancers), and valvular heart disease (3 of 18 cancers) (by adjusted HRs, p<0.01 for all). Survivors of hematological malignancies were at increased risk of all cardiovascular outcomes, whereas the risk pattern was more varied for survivors of other types of cancers. Furthermore, there was an increased risk of heart failure or cardiomyopathy and venous thromboembolism in younger patients and patients without previous cardiovascular disease in a variety of cancers; this risk was most pronounced in patients who had received chemotherapy. Overall, results from this study suggest that cancer survivors are at an increased risk of multiple cardiovascular disease as compared to the general population, underlining a need for more intensive cardiovascular disease screening, prevention, and management strategies in this patient population.
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