Eur J Prev Cardiol. 2023 Jul 27:zwad243. doi: 10.1093/eurjpc/zwad243. Online ahead of print.
ABSTRACT
BACKGROUND: It is unclear whether the future risk of cardiovascular events in breast cancer (BC) survivors is greater than in the general population.
OBJECTIVES: This meta-analysis quantifies the risk of cardiovascular disease development in breast cancer patients, compared to the risk in a general matched cancer-free population and reports the incidence of cardiovascular events in patients with BC.
METHODS: We searched PubMed, Scopus, and Web of Science databases (up to March 23, 2022) for observational studies and post-hoc analyses of RCTs. Cardiovascular death, heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), stroke were the individual endpoints for our meta-analysis. We pooled incidence rates (IRs) and risk in hazard ratios (HRs), using random-effects meta-analyses. Heterogeneity was reported through the I^2 statistic, and publication bias was examined using funnel plots and Egger’s test in the meta-analysis of risk.
RESULTS: 142 studies were identified in total, 26 (836,301 patients) relevant to the relative risk, and 116 (2,111,882 patients) relevant to IRs. Compared to matched cancer-free controls, BC patients had higher risk for cardiovascular death within five years of cancer diagnosis (HR = 1.09; 95% CI: 1.07, 1.11), HF within ten years (HR = 1.21; 95% CI: 1.1, 1.33), and AF within three years (HR = 1.13; 95% CI: 1.05, 1.21). The pooled IR for cardiovascular death was 1.73 (95% CI 1.18, 2.53), 4.44 (95% CI 3.33, 5.92) for HF, 4.29 (95% CI 3.09, 5.94) for CAD, 1.98 (95% CI 1.24, 3.16) for MI, 4.33 (95% CI 2.97, 6.30) for stroke of any type, and 2.64 (95% CI 2.97, 6.30) for ischemic stroke.
CONCLUSION: breast cancer exposure was associated with the increased risk for cardiovascular death, HF and AF. The pooled incidence for cardiovascular endpoints varied depending on population characteristics and endpoint studied.
PMID:37499186 | DOI:10.1093/eurjpc/zwad243
