Gon Yasufumi, Zha Ling, Kawano Tomohiro, Kudo Haruka, Morishima Toshitaka, Sasaki Tsutomu, Miyashiro Isao, Mochizuki Hideki, Sobue Tomotaka
Department of Neurology Osaka University Graduate School of Medicine Osaka Japan.
Cancer Control Center Osaka International Cancer Institute Osaka Japan.
J Am Heart Assoc. 2025 May 20;14(10):e037965. doi: 10.1161/JAHA.124.037965. Epub 2025 May 15.
Improvements in cancer survivorship have led to concern about cardiovascular disease (CVD) among cancer survivors. This study aimed to investigate CVD mortality in patients with cancer compared with the general population, with a focus on specific CVDs including ischemic heart disease, heart failure, aortic dissection, ischemic stroke, and hemorrhagic stroke.
This nationwide population-based cohort study used data from the National Cancer Registry in Japan. Patients diagnosed with cancer between January 2016 and December 2019 were included. Standardized mortality ratios (SMRs) and their 95% CIs were calculated to compare the risk of CVD mortality between patients with cancer and the general population. The SMRs were also computed for each specific CVD.
The study included 3 972 603 patients, representing 6 212 672 person-years of follow-up. Patients with cancer had a 2.39-fold higher risk of cardiovascular death compared with the general population. The SMR was highest for nonlymphoid hematologic malignancies (4.32 [95% CI, 4.15-4.50]). The mortality risk varied across specific types of CVD. Nonlymphoid hematologic malignancies had the highest SMRs for ischemic heart disease (3.15 [95% CI, 2.87-3.45]) and heart failure (7.65 [95% CI, 7.07-8.27]). The SMR for aortic dissection, ischemic stroke, and hemorrhagic stroke were highest for laryngeal (3.31 [95% CI, 2.29-4.79]), pancreatic (5.39 [95% CI, 4.79-6.05]), and liver (3.75 [95% CI, 3.36-4.18]) cancers, respectively.
Patients with cancer had a higher CVD mortality risk, which was prominent in nonlymphoid hematologic malignancies. The mortality risk varied considerably by cancer type and specific CVD type.
癌症幸存者生存率的提高引发了对其心血管疾病（CVD）的关注。本研究旨在调查癌症患者与普通人群相比的心血管疾病死亡率，重点关注特定的心血管疾病，包括缺血性心脏病、心力衰竭、主动脉夹层、缺血性卒中和出血性卒中。
这项基于全国人群的队列研究使用了日本国家癌症登记处的数据。纳入了2016年1月至2019年12月期间被诊断为癌症的患者。计算标准化死亡率（SMR）及其95%置信区间（CI），以比较癌症患者与普通人群的心血管疾病死亡风险。还针对每种特定的心血管疾病计算了SMR。
该研究纳入了3972603名患者，随访时间总计6212672人年。癌症患者的心血管死亡风险比普通人群高2.39倍。非淋巴造血系统恶性肿瘤的SMR最高（4.32[95%CI，4.15 - 4.50]）。不同类型的心血管疾病死亡率风险各不相同。非淋巴造血系统恶性肿瘤在缺血性心脏病（3.15[95%CI，2.87 - 3.45]）和心力衰竭（7.65[95%CI，7.07 - 8.27]）方面的SMR最高。主动脉夹层、缺血性卒中和出血性卒中的SMR分别在喉癌（3.31[95%CI，2.29 - 4.79]）、胰腺癌（5.39[95%CI，4.79 - 6.05]）和肝癌（3.75[95%CI，3.36 - 4.18]）中最高。
癌症患者的心血管疾病死亡风险更高，在非淋巴造血系统恶性肿瘤中尤为突出。死亡率风险因癌症类型和特定心血管疾病类型而异。
