Engebretsen Ingrid, Oteiza Francisco, Birkelund Elisabeth Floberghagen, Brandal Signe Marie, Bugge Christoffer, Halvorsen Sigrun
Oslo Economics, Klingenberggata 7A, 0161 Oslo, Norway.
Pfizer AS, Drammensveien 288, 0283 Oslo, Norway.
Eur Heart J Open. 2025 Apr 23;5(3):oeaf043. doi: 10.1093/ehjopen/oeaf043. eCollection 2025 May.
Various measures have been implemented in clinical practice to reduce the risk of cardiovascular complications during breast cancer (BC) treatment. The aim of this study was to investigate whether women diagnosed with BC exhibit a higher incidence of cardiovascular disease (CVD).
Matched cohort study. Using data from the Cancer Registry of Norway and the Norwegian Patient Registry, we created a nationwide cohort of women diagnosed with BC between 2013 and 2020 and age-matched controls (matching ratio 1:10). For BC patients, the index date was the date of their BC diagnosis. For controls, the index date was a random date within the index year of the matched BC patient. For eight selected CVDs, we compared the prevalence before BC diagnosis between cases and controls, as well as the overall incidence, hazard ratios (HRs), and cumulative incidences post BC diagnosis. Follow-up was through 2021. Our study population consisted of 27 526 BC patients and 269 904 matched controls. Among the subset of patients without CVD prior to index, BC patients had significantly increased overall and cumulative risk of pulmonary embolism (HR = 3.00, 95% CI: [2.51-3.59]), atrial fibrillation (1.53 [1.38-1.70]), other cardiac arrhythmias (1.43 [1.27-1.61]), heart failure (1.93 [1.33-2.80]), hypertensive heart disease (1.79 [1.67-1.91]), and heart valve disease (2.02 [1.79-2.27]).
In this contemporary cohort, BC patients still had an increased risk of several CVDs compared to age-matched controls. Further research is needed to determine the causes of this increased risk, but clinicians should be aware and optimize therapy accordingly.
临床实践中已采取多种措施来降低乳腺癌（BC）治疗期间心血管并发症的风险。本研究的目的是调查被诊断为BC的女性是否心血管疾病（CVD）发病率更高。
匹配队列研究。利用挪威癌症登记处和挪威患者登记处的数据，我们创建了一个全国性队列，其中包括2013年至2020年间被诊断为BC的女性以及年龄匹配的对照组（匹配比例为1:10）。对于BC患者，索引日期为其BC诊断日期。对于对照组，索引日期为匹配的BC患者索引年内的随机日期。对于八种选定的CVD，我们比较了病例组和对照组在BC诊断前的患病率，以及BC诊断后的总体发病率、风险比（HRs）和累积发病率。随访至2021年。我们的研究人群包括27526例BC患者和269904例匹配的对照组。在索引前无CVD的患者亚组中，BC患者发生肺栓塞的总体和累积风险显著增加（HR = 3.00，95%CI：[2.51 - 3.59]）、心房颤动（1.53 [1.38 - 1.70]）、其他心律失常（1.43 [1.27 - 1.61]）、心力衰竭（1.93 [1.33 - 2.80]）、高血压性心脏病（1.79 [1.67 - 1.91]）和心脏瓣膜病（2.02 [1.79 - 2.27]）。
在这个当代队列中，与年龄匹配的对照组相比，BC患者患几种CVD的风险仍然增加。需要进一步研究以确定这种风险增加的原因，但临床医生应予以关注并相应地优化治疗。
