MELBOURNE, AUSTRALIA — Cardiovascular disease (CVD) is a greater risk for cancer survivors because of either their malignancy or its treatment.

Yet, according to a new study, little of the research examine risk in older adults, the impact of cancer treatment or the effect of aspirin on reducing risk in this cohort.

The authors, led by Monash University in Melbourne, Australia, and including researchers from Walter Reed National Military Medical Center in Bethesda, MD, conducted a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial. Their goal was to investigate the impact of cancer and cancer treatment on a composite CVD endpoint comprising hospitalization for heart failure (HHF), myocardial infarction (MI) and stroke.

Of 15,454 Australian and U.S. ASPREE participants, 1,392 had an incident cancer diagnosis, according to a report published in the journal Cancer.1

Results indicated that rates of CVD were greater in the cancer risk-set compared to the cancer-free risk-set (20.8 vs. 10.3 events per 1,000 person-years; incidence rate ratio, 2.03; 95% confidence interval, 1.51-2.66). Increased incidence was identified with MI, HHF, overall stroke and ischemic stroke. Increased incidence, which remained after adjustment for clinically significant risk factors for CVD, was greatest in metastatic, hematological and lung cancer.

In addition, chemotherapy was associated with increased risk of CVD. Similar rates of CVD were seen across aspirin and placebo groups, however, according to the authors.

“Incidence of CVD, including MI, HHF and ischemic stroke, was increased in older adults with cancer,” the researchers concluded. “Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.”

 

  1. Muhandiramge J, Zalcberg JR, Warner ET, Polekhina G, et. Al. Cardiovascular disease and stroke following cancer and cancer treatment in older adults. Cancer. 2024 Dec 1;130(23):4138-4148. doi: 10.1002/cncr.35503. Epub 2024 Sep 23. PMID: 39308168; PMCID: PMC11560579.