Gilberto Lopes, Chief of the Division of Medical Oncology at the Sylvester Comprehensive Cancer Center, shared on LinkedIn:
“When cancer strikes young, the heart matters too.
Our new systematic review and meta-analysis was published today in Cancers.
As treatments improve and more young patients survive cancer, we must pay greater attention to what happens years – and sometimes decades – after diagnosis.
Together with Musa Kiyani, Robert Heins, John Hayssam Yazji, and Harith Almimar, we examined the cardiovascular burden among younger patients with cancer.
We included 58 studies from 36 unique cohort sources, evaluating cardiovascular outcomes relative to non-cancer or general-population reference groups.
The findings are concerning.
- Pooled hazard ratios (95% CIs):
- Pulmonary embolism: 4.63 (3.03–7.06).
- Heart failure: 4.08 (2.20–7.57).
- Venous thrombosis: 4.06 (2.51–6.58).
- Cardiomyopathy: 3.52 (2.21–5.63).
- Arrhythmia: 1.37 (1.19–1.58).
- Stroke: 1.33 (1.10–1.61).
Cardiovascular mortality was elevated, but its magnitude was highly uncertain because of extreme heterogeneity (I²=99.1%) and sensitivity to potential publication bias.
What does this mean for clinical practice?
Cancer survivorship is not simply the absence of recurrence. Patients treated during adolescence and young adulthood may live for decades after diagnosis. Long-term health depends not only on cancer control but also on recognizing and managing cardiovascular risk.
Our findings reinforce individualized cardiovascular risk assessment and guideline-informed survivorship follow-up, particularly after known cardiotoxic exposures.
But important limitations remain. These were observational studies spanning different cancers, ages, treatments, and eras. Most outcomes had low-certainty evidence. We could not separate cancer-related risks from treatment-related cardiotoxicity. Nor does this meta-analysis establish that more intensive cardiac surveillance improves outcomes.
Successful cancer treatment should be measured not only by how long patients live, but how well they live afterward.
Congratulations and thanks to Musa Kiyani and our coauthors. This is a topic deserving continued collaboration across oncology and cardiology.”
Title: Excess Cardiovascular Burden Among Young Patients with Cancer: A Systematic Review and Meta-Analysis
Authors: Musa Kiyani, Robert Heins, John Hayssam Yazji, Harith Almimar, Gilberto de Lima Lopes Jr.
Read the Full Article.
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