Active cancer treatment linked to increased risk for sudden cardiac arrest
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Key takeaways:
- Patients with multiple risk factors had significantly higher risk for SCD 6 months after cancer treatment.
- Risk factors included age less than 74 years, history of heart failure and treatment for lung cancer.
Active cancer treatment is associated with increased risk for sudden cardiac death, especially among patients younger than 74 years old and those with a history of heart failure, results from a retrospective study showed.
The findings, published in The American Journal of Cardiology, indicated that patients who harbored multiple risk factors had a significantly higher probability of sudden cardiac death 6 months after the start of cancer treatment compared with those who had only one or no risk factor.
“These data suggest that the proportion of patients who experience [sudden cardiac death] during treatment differs among different malignancies, in part, by either the natural history of the disease and or the type of cancer treatment,” Saadia Sherazi, MD, MS, assistant professor in the department of medicine at University of Rochester School of Medicine, and colleagues wrote. “Thus, our findings show that simple clinical [risk factors] and the type of cancer can identify patients with increased risk for [sudden cardiac death] during cancer treatment.”
Background, methods
Prior to this study, limited data had been established on the risk for sudden cardiac death (SCD) among patients with cancer while receiving treatment.
Researchers conducted a retrospective analysis to evaluate both the risk for SCD during the first 6 months of cancer treatment and to identify any potential risk factors for SCD for patients undergoing active cancer treatment.
The study cohort included 8,356 individuals with cancer (mean age, 64 years; 49% women) who received any cancer treatment at University of Rochester Medical Center between 2011 and 2020.
Occurrence of SCD within 6 months of cancer treatment served as the study’s primary endpoint.
Results, next steps
Researchers noted that all-cause mortality occurred in 834 patients (10%), with 51 patients (6%) having been identified as dying due to SCD. Results showed a 0.6% cumulative probability of SCD at 6 months.
Sherazi and colleagues identified being younger than 74 years old, a history of congestive heart failure and lung cancer as independent risk factors for SCD through multivariate Cox regression models.
Additionally, the cumulative probability of SCD at 6 months from cancer treatment initiation appeared to be significantly higher in patients with at least two risk factors than in patients with one or no risk factors.
Potential study limitations included having defined SCD according to the Hinkle-Thaler criteria, which allows for some SCD cases to be counted despite potentially not being arrhythmic in nature due to ECG monitoring not being performed at time of death.
Additionally, this study only includes a small number of SCD cases.
The results indicate that potential risk factors for certain patients within the first 6 months of receiving active cancer treatment, with future studies needed to address modalities for prevention and protection among this patient population, according to researchers.
“Our findings suggest an increased risk [for] SCD in non-elderly patients and those with a history of heart failure and lung cancer,” researchers wrote. “We also observed higher rates of SCD in patients with lung cancers, suggesting that the risk [for] SCD differs among different malignancies. As oncologic treatments continue to advance, there is a need to improve our understanding of cardiovascular toxicities associated with cancer treatments and their potential impacts on patient prognosis.”
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Sherazi S, et al. AM J Cardiol. 2024;doi:10.1016/j.amjcard.2023.12.012.
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