Commentary: Cancer Survivorship and Subclinical Myocardial Damage

The rate of cardiovascular disease among cancer survivors is higher than in the general population. This difference is due to traditional cardiovascular disease (CVD) risk factors and also to the cardiotoxicity of cancer treatment. In a population-based cohort study of 3,512 men and women who were free of CVD at visit 5 of a large, community-based cohort study, Florido et al. (Am J Epidemiol. 2019;188(12):2188-2195) evaluated the association of cancer survivorship with subclinical myocardial damage, as assessed by elevated high-sensitivity cardiac troponin T (hs-cTnT). Cancer survivors had significantly higher odds of elevated hs-cTnT (odds ratio = 1.26, 95% confidence interval: 1.03, 1.53). Results were similar for survivors of non-sex-related and colorectal cancers. There was no association between survivorship from breast and prostate cancers and elevated hs-cTnT. The findings of Florido et al. indicate that survivors of some cancers might be more likely to have elevated hs-cTnT than patients without prior cancer. These findings have important implications because identifying cancer survivors who have elevated CVD risk is of paramount importance in order to prevent CVD manifestations such as heart attack, congestive heart failure, or stroke. Additional research is needed to clarify the associations of elevated hs-cTnT levels among survivors of specific cancer sites, stage at diagnosis, and histologic types.