VIVE, The Danish Center for Social Science Research, Copenhagen, Denmark.
VIVE, The Danish Center for Social Science Research, Aarhus, Denmark.
Acta Oncol. 2021 Oct;60(10):1257-1263. doi: 10.1080/0284186X.2021.1959054. Epub 2021 Aug 2.
Only few existing studies have investigated the mortality from cardiovascular disease (CVD) in women with breast cancer (BC). The aim of this study was to investigate CVD mortality in patients with BC compared with a matched control group without BC using national registry data.
We followed 16,505 Danish women diagnosed with BC in 2003-2007 up to 10 years after BC diagnosis compared with 165,042 matched controls from the general Danish population. The matching criteria included gender, age, region of residence, and education. We performed multivariate Cox regression analyses to investigate the influence of preexisting CVD on mortality. Moreover, we used the cumulative incidence and conditional probability functions to study the risk of CVD-related death in the presence of competing risk, i.e., the risk of dying from other causes than CVD.
We found that preexisting CVD increased both overall mortality and CVD mortality in both patients with BC and controls. Furthermore, we found that patients with BC were at lower risk of dying from CVD up to 10 years after BC diagnosis compared with controls. The cumulative incidence of CVD as underlying cause of death was 4.0% in patients with BC and 5.7% in controls after 10 years. The most common CVD-related causes of death were ischemic heart disease including acute coronary syndrome, cerebrovascular accident, heart failure, and atrial fibrillation.
Our study contributes to the growing body of work on BC and comorbidities and highlights the importance of CVD in individuals with BC. Further studies are needed to confirm our finding that patients with BC are at lower risk of dying from CVD up to 10 years after BC diagnosis compared with a matched control group without BC.
仅有少数现有研究调查了乳腺癌（BC）女性的心血管疾病（CVD）死亡率。本研究旨在使用国家登记数据，调查 BC 患者与无 BC 的匹配对照组相比 CVD 死亡率。
我们对 2003-2007 年间诊断为 BC 的 16505 名丹麦女性进行了随访，最长随访 10 年，与来自一般丹麦人群的 165042 名匹配对照组进行比较。匹配标准包括性别、年龄、居住地区和教育程度。我们进行了多变量 Cox 回归分析，以调查预先存在的 CVD 对死亡率的影响。此外，我们使用累积发病率和条件概率函数来研究在存在竞争风险（即死于 CVD 以外原因的风险）的情况下，与 CVD 相关的死亡风险。
我们发现预先存在的 CVD 增加了 BC 患者和对照组的总死亡率和 CVD 死亡率。此外，我们发现 BC 患者在 BC 诊断后 10 年内死于 CVD 的风险较低。作为死亡根本原因的 CVD 的累积发病率为 BC 患者 4.0%，对照组为 5.7%，10 年后。最常见的与 CVD 相关的死亡原因是缺血性心脏病，包括急性冠状动脉综合征、脑血管意外、心力衰竭和心房颤动。
我们的研究为 BC 和合并症的研究做出了贡献，强调了 CVD 在 BC 个体中的重要性。需要进一步的研究来证实我们的发现，即与无 BC 的匹配对照组相比，BC 患者在 BC 诊断后 10 年内死于 CVD 的风险较低。
