PO-58 - Cardiovascular risk profile in survivors of adult cancer - results from the general population study

M Panova-Noeva; I M Hermanns; A Schulz; D Laubert-Reh; T Zeller; S Blankenberg; H M Spronk; T Münzel; K J Lackner; H Ten Cate; P S Wild

doi:10.1016/S0049-3848(16)30191-8

PO-58 - Cardiovascular risk profile in survivors of adult cancer - results from the general population study

Thromb Res. 2016 Apr:140 Suppl 1:S198. doi: 10.1016/S0049-3848(16)30191-8. Epub 2016 Apr 8.

Authors

M Panova-Noeva¹, I M Hermanns¹, A Schulz², D Laubert-Reh², T Zeller³, S Blankenberg³, H M Spronk⁴, T Münzel⁵, K J Lackner⁶, H Ten Cate⁴, P S Wild⁷

Affiliations

¹ Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz.
² Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz; Mainz.
³ Department of General and Interventional Cardiology, University Heart Centre, Hamburg-Eppendorf; DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg; Germany.
⁴ Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, The Netherlands.
⁵ Center for Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz; DZHK (German Center for Cardiovascular Research), Partner Site RhineMain.
⁶ DZHK (German Center for Cardiovascular Research), Partner Site RhineMain; Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz; Mainz, Germany.
⁷ Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz; Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz; Mainz; DZHK (German Center for Cardiovascular Research), Partner Site RhineMain.

PMID: 27161747
DOI: 10.1016/S0049-3848(16)30191-8

Abstract

Introduction: The advancements in cancer treatment and detection of early cancer have resulted in steady increase of adult cancer survivors over the years. However, due to the long term toxic effects of chemotherapy and radiotherapy, the incidence of cardiovascular diseases (CVD) is increasing in survivors. Identifying risk factors and interventions to reduce the excess burden of CVD in this vulnerable population is urgently needed.

Aim: To investigate the cardiovascular risk factors (CVRFs), inflammation and coagulation profile in cancer survivors from a large population-based study.

Materials and methods: Presence of CVRFs and laboratory markers have been compared in individuals with (n=1,359) and without (n=13,626) history of cancer. Standard laboratory profile, including blood glucose and lipid profile, has been evaluated in 15,010 individuals from the Gutenberg Health Study (GHS). Coagulation factors, D-dimer and von Willebrand factor (vWF) activity were available in N=4,993.

Results: The individuals with history of cancer were older compared to no history of cancer with mean age of 61,5years and 54.4years, respectively (p<0.001). Traditional CVRFs as diabetes (14% vs 8.8%), dyslipidemia (49.6% vs 43.7%) and hypertension (60.3 vs 48.7%) were more frequent whereas smoking was less frequent (14.5% vs 19.9%) in cancer survivors (p<0.001). The standard laboratory profile showed cancer survivors with lower erythrocyte, platelet and white blood cell counts and higher C-reactive protein (CRP), glucose, HbA1c and triglycerides levels (p<0.001). Multivariable logistic regression analysis adjusted for age, sex and CVRFs demonstrated an independent association with diabetes (odds ratio, OR: 1.24, 1.02-1.50; p=0.027) and higher CRP (OR: 1.01, 1.01-1.02; p=0.00071). Fibrinogen, FV, FVII, FVIII and FXI, D-dimer and vWF activity were higher in cancer survivors (p<0.001). Multivariable logistic regression confirmed an independent association with higher fibrinogen (OR: 1.002, 1.000-1.003) and vWF activity (OR: 1.005, 1.001-1.008).

Conclusions: This is the first study investigating CVRFs, inflammation and coagulation profile in individuals with history of cancer from a well characterized population-representative adult sample. It gives evidence for higher prevalence of CVRFs, particularly diabetes in this vulnerable population. Markers of inflammation as CRP and fibrinogen and vWF activity were higher in cancer survivors independent of the cardiovascular risk profile. These results underline the increased risk of CVD and need for development of cardio-oncology programs offering cardiovascular prevention.