Incidence of cancers in patients with atherosclerotic cardiovascular diseases

Abstract

Background: To address a clinical impact of atherosclerotic cardiovascular diseases (CVD) on cancer developments, we investigated an issue whether any difference in an incidence of cancers is present between patients with atherosclerotic CVD and those with non-atherosclerotic CVD.

Methods: Of a total of 32,095 consecutive patients with acquired CVD enrolled in the Sakakibara Health Integrative Profile cohort study, we segregated patients based on a presence of atherosclerotic or non-atherosclerotic CVD to investigate an incidence of cancers and mortality. We also evaluated an incidence of cancers in patients with a singular presence versus a plural presence of atherosclerotic CVD. Atherosclerotic CVD included coronary artery diseases, aortic diseases and peripheral artery diseases. Non-atherosclerotic CVD were any acquired CVD except atherosclerotic CVD.

Results: During a median follow-up of 1020 days (interquartile range, 665-1340 days), an incidence of cancers (5% vs. 2%, p = 0.0001) and overall mortality (6% vs. 3%, p = 0.0001) were more than two-fold higher in 10,592 patients with atherosclerotic CVD than in 21,503 patients with non-atherosclerotic CVD. A presence of atherosclerotic CVD (hazard ratio 1.372 with 95% confidence interval 1.199-1.569) was independently associated with an incidence of cancers. In patients with atherosclerotic CVD, 61 of 640 patients with a plural presence and 470 of 9932 patients with a singular presence developed cancers (9% vs. 5%, p = 0.0001). An incremental risk of death was found according to a presence of atherosclerotic CVD, cancers, and both of them (all p = 0.0001).

Conclusions: A presence of atherosclerotic CVD itself may have a potential risk for cancer developments.

Trial registration: ClinicalTrials.gov. number, NCT03005834.

Keywords: Atherosclerotic cardiovascular diseases; Cancers; Mortality; The SHIP cohort study.

Fig. 1

Flow diagram of the study design showing the first (A) and second (B) steps for analysis. CVD = cardiovascular diseases.

Fig. 2

Cumulative probability of cancer developments in all the patients (A) and following adjustment for baseline characteristics (B), according to patients with atherosclerotic CVD or non-atherosclerotic CVD. The multivariate Cox proportional hazards regression analysis for cancer developments in each disease in atherosclerotic CVD (C). Cumulative probability of cancer developments in patients with a singular presence and a plural presence of atherosclerotic CVD after adjustment for baseline clinical characteristics (D). CVD = cardiovascular diseases, 95% C.I. = 95% confidence intervals.