Prevalence of Cardiovascular Disease in Patients With Potentially Curable Malignancies: A National Registry Dataset Analysis

Nicolò Matteo Luca Battisti; Catherine A Welch; Michael Sweeting; Mark de Belder; John Deanfield; Clive Weston; Michael D Peake; David Adlam; Alistair Ring

doi:10.1016/j.jaccao.2022.03.004

Prevalence of Cardiovascular Disease in Patients With Potentially Curable Malignancies: A National Registry Dataset Analysis

JACC CardioOncol. 2022 Jun 21;4(2):238-253. doi: 10.1016/j.jaccao.2022.03.004. eCollection 2022 Jun.

Authors

Nicolò Matteo Luca Battisti^{1

2}, Catherine A Welch^{3

4}, Michael Sweeting^{3

4}, Mark de Belder^{5

6}, John Deanfield⁷, Clive Weston^{8

9

10}, Michael D Peake^{4

11}, David Adlam^{12

13}, Alistair Ring^{1

2}

Affiliations

¹ Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
² Breast Cancer Research Division, The Institute of Cancer Research, London, United Kingdom.
³ Biostatistics Research Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
⁴ Public Health England, London, United Kingdom.
⁵ National Institute for Cardiovascular Outcomes Research, London, United Kingdom.
⁶ Barts Health NHS Trust, London, United Kingdom.
⁷ Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
⁸ Myocardial Ischaemia National Audit Project.
⁹ School of Medicine, Swansea University, Swansea, United Kingdom.
¹⁰ Glangwili General Hospital, Carmarthen, United Kingdom.
¹¹ University of Leicester, Leicester, United Kingdom.
¹² Department of Cardiovascular Sciences, University of Leicester and Leicester National Institute of Health Research Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.
¹³ University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

Abstract

Background: Although a common challenge for patients and clinicians, there is little population-level evidence on the prevalence of cardiovascular disease (CVD) in individuals diagnosed with potentially curable cancer.

Objectives: We investigated CVD rates in patients with common potentially curable malignancies and evaluated the associations between patient and disease characteristics and CVD prevalence.

Methods: The study included cancer registry patients diagnosed in England with stage I to III breast cancer, stage I to III colon or rectal cancer, stage I to III prostate cancer, stage I to IIIA non-small-cell lung cancer, stage I to IV diffuse large B-cell lymphoma, and stage I to IV Hodgkin lymphoma from 2013 to 2018. Linked hospital records and national CVD databases were used to identify CVD. The rates of CVD were investigated according to tumor type, and associations between patient and disease characteristics and CVD prevalence were determined.

Results: Among the 634,240 patients included, 102,834 (16.2%) had prior CVD. Men, older patients, and those living in deprived areas had higher CVD rates. Prevalence was highest for non-small-cell lung cancer (36.1%) and lowest for breast cancer (7.7%). After adjustment for age, sex, the income domain of the Index of Multiple Deprivation, and Charlson comorbidity index, CVD remained higher in other tumor types compared to breast cancer patients.

Conclusions: There is a significant overlap between cancer and CVD burden. It is essential to consider CVD when evaluating national and international treatment patterns and cancer outcomes.

Keywords: CVD, cardiovascular disease; DLBCL, diffuse large B-cell lymphoma; HES, Hospital Episode Statistics; ICD-10, International Statistical Classification of Diseases and Related Health Problems-10th Revision; NCRD, National Cancer Registration Dataset; NICOR, National Institute for Cardiovascular Outcomes Research; NSCLC, non-small-cell lung cancer; breast cancer; colorectal cancer; lung cancer; lymphoma; prostate cancer.