Risk for Cardiovascular Disease Greater for Childhood Cancer Survivors

Survivors of childhood cancer have an increased risk for all subtypes of cardiovascular disease (CVD), according to a research letter published online Aug. 26 in Circulation.

Ashna Khanna, from the University of Toronto, and colleagues examined the correlation between baseline characteristics and cancer treatments and CVD rates among 7,289 five-year childhood cancer survivors and 36,205 matched cancer-free individuals.

The researchers found that during a median follow-up of 10 years from index, 2.8 and 0.9 percent of survivors and controls, respectively, experienced one or more cardiac events. There were 3.2 cardiac events per 1,000 person-years among survivors compared with 0.9 per 1,000 person-years for the general population. Survivors had an increased incidence of any cardiac event, heart failure, arrhythmia, pericardial disease, valvular disease, and coronary artery disease (hazard ratios, 3.2, 9.7, 1.9, 1.8, 4.7, and 3.4, respectively). Among survivors, increased risks for CVD were seen in association with childhood relapse/subsequent cancer (hazard ratio, 1.7), exposure to ≥250 mg/m² of doxorubicin-equivalent anthracycline chemotherapy (hazard ratio 2.0), and diabetes mellitus preceding cardiac disease diagnosis (hazard ratio, 3.0). Statistically significant predictors of heart failure included childhood relapse/subsequent cancer (hazard ratio, 2.0), exposure to ≥250 mg/m² of doxorubicin-equivalent anthracycline chemotherapy (hazard ratio, 8.6), diabetes (hazard ratio, 4.3), and hypertension (hazard ratio, 3.1).

"Because the prevalence of CVD is expected to increase with age, this study reinforces the need for periodic CVD surveillance, and consideration of all CVD types, in childhood cancer survivors," the authors write.

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