CV admission rates increase among patients with cancer
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Rates for CV admissions among patients with cancer has increased, according to a study published in the European Heart Journal Quality of Care & Clinical Outcomes.
Primary CV admissions are highest among patients with hematological cancer with the most common cause of admission being heart failure, according to the study.
“Our main findings are an overall increasing trend of primary cardiovascular admissions in patients with concurrent cancer and a decreasing trend of in-hospital mortality related to these admissions,” Ofer Kobo, MD, of the Keele Cardiovascular Research Group at Keele University, and colleagues wrote.
Kobo and colleagues analyzed more than 42.5 million hospitalizations included in the National Inpatient Sample database between 2004 and 2017 with a primary CV diagnosis: acute MI, pulmonary embolism, ischemic stroke, HF, atrial fibrillation/atrial flutter or intracranial hemorrhage.
Of 1,895,823 patients (mean ages, 72 to 79 years) with active cancer diagnosis, 26.1% had hematological malignancy, 18.7% had lung malignancy, 12.4% had gastrointestinal cancer, 11.6% had prostate cancer, 6.7% had breast malignancies and 24.4% presented with other types of malignancies.
During the study period, CV admission rates rose by 23.2% in patients with cancer but dropped by 10.9% in patients without cancer, according to the researchers.
Patients with cancer had higher prevalence of valvular disease, anemia and coagulopathy and had lower prevalence of hypertension, diabetes and obesity compared with patients without cancer, according to the study.
The highest prevalence of hypertension and peripheral artery disease was among patients with prostate cancer, while patients with hematological malignancies had the greatest burden of valvular heart disease, chronic renal failure, anemia and coagulopathies.
HF was the most common CV-related admission among patients with cancer, and had an increasing rate during the study period from 13.6 (95% CI, 13.5-13.7) to 16.6 (95% CI, 16.4-16.7) per 100,000 people (P = .02). PE was the second most common, with an increasing rate from 6.4 (95% CI, 6.3-6.5) per 100,000 people in 2004 to 8.8 (95% CI, 8.7-8.9) per 100,000 people in 2017 (P < .001).
Intracranial hemorrhage was the least common CV-related reason for admission, but admission rates significantly increased from 2004 (1.8 per 100,000 people; 95% CI, 1.7-1.8) to 2017 (2.5 per 100,000 people; 95% CI, 2.5-2.6; P < .001).
“Our study illustrates increasing cardiovascular health care needs of cancer patients and growing importance of awareness of related issues by the general cardiologist,” Kobo and colleagues wrote. “Further studies are needed in order to explore the underlying reasons of these trends.”
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