High Incidence of Cardiovascular Disease in Patients With Oesophageal Cancer-A Registry-Based Cohort Study

Mette Marie A Søndergaard; Marianne Nordsmark; Kirsten M Nielsen; Jan B Valentin; Søren P Johnsen; Steen H Poulsen

doi:10.1016/j.hlc.2023.12.015

High Incidence of Cardiovascular Disease in Patients With Oesophageal Cancer-A Registry-Based Cohort Study

Heart Lung Circ. 2024 Feb 8:S1443-9506(24)00002-7. doi: 10.1016/j.hlc.2023.12.015. Online ahead of print.

Authors

Mette Marie A Søndergaard¹, Marianne Nordsmark², Kirsten M Nielsen³, Jan B Valentin⁴, Søren P Johnsen⁴, Steen H Poulsen³

Affiliations

¹ Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark; Department of Medicine, Regional Hospital Horsens, Horsens, Denmark. Electronic address: metast@rm.dk.
² Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark.
³ Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.
⁴ Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg Ø, Denmark.

PMID: 38336543
DOI: 10.1016/j.hlc.2023.12.015

Abstract

Background: The cardiovascular disease (CVD) burden among patients with oesophageal cancer (EC) treated with curative intent is unclear.

Aim: To determine CVD incidence and all-cause mortality in patients with EC.

Method: Danish national health registries were used to identify patients diagnosed with primary EC between 2008 and 2018. Each EC patient was matched with ten individuals from the general population. The primary endpoint was a CVD hospital contact (CVD-HC), either admission or outpatient contact. Cox proportional hazard regression models were used to compare the risk of incident CVD-HCs between the cohorts.

Results: The study included 1,525 patients with EC and 15,250 individuals from the general population. Patients with EC had a post-diagnosis one-year adjusted hazard ratio (HR) of CVD-HC of 6.1 (95% confidence intervals [CIs] 5.6-6.8) compared with the general population. During the next nine years, the risk of CVD-HC was comparable between the two cohorts, with an adjusted HR of 1.0 (95% CI 0.9-1.3). Patients with EC, and particularly those with prevalent CVD, had a high risk of atrial fibrillation, ischaemic heart disease, and venous thromboembolism within the first year after EC diagnosis. Prevalent CVD among patients with EC was not associated with higher mortality.

Conclusions: CVD morbidity was transiently increased in the first year following EC diagnosis compared with the general population. All-cause mortality risks were high but did not appear to be affected by prevalent CVD. The very high risk of CVD in patients with primary EC to be treated with curative intent calls for healthcare initiatives to advance preventive and post-treatment strategies.

Keywords: Cardio-oncology; Cardiovascular disease; Epidemiology; Oesophageal cancer.

Copyright © 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.