Risk of cardiovascular mortality in patients with gastric cancer

1. In this cohort of patients with gastric cancer, there was a significantly higher risk of cardiovascular death compared with the general population. 

Evidence Rating Level: 2 (Good)

Gastric Cancer (GC) remains the fifth highest in both prevalence and mortality for types of cancer worldwide, with a 5-year survival rate of 25%. Among these patients, cardiovascular disease (CVD) accounts for 5.9% of mortalities, owing to CVD and GC sharing many risk factors, as well as many GC treatments being cardiotoxic. This study aims to show estimates of CVD mortality risk in GC patients compared to the general population. 41,083 GC patients from the Surveillance, Epidemiology, and End Results (SEER) registry were examined, with 2,288 deaths attributed to CVD (mortality rate: 1.91 per 100 person-years), a higher rate than the general population (mortality rate: 0.50 per 100 person-years) (IRR 1.46, 95% CI 1.40–1.52). Patients who underwent radiotherapy, which has a known association with inflammation, had an increased CVD risk. Higher risk was seen at the first month after diagnosis (IRR 11.52, 95% CI 9.97–13.31), likely owing to a combination of stresses, GC being thrombosis-prone, surgery risks and some first-line regimens’ cardiotoxicity. The risk decreased with age (IRR declining from 3.03 at age 40 to 1.25 at age 80), suggesting that early cardiovascular intervention may be particularly beneficial. The population-based cohort study helps limit selection and recency bias; however, it is limited in being able to adjust for CVD risk factors. Overall, the links between CVD and GC show the need for a multidimensional assessment between the two, with prioritized interventions at certain points showing potential.

Click here to read this study in PLOS One

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