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Long-Term Risks of Cardiovascular Death among Older Patients with Major Hematological Malignancies: A

Hanqing Zhang1,2, Minghao He2,3, Peng Zhang2,3

  • 1Guangzhou University of Chinese Medicine, Guangzhou, China.

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
|May 7, 2024
PubMed

Insights

Older patients with hematological malignancies face a significantly higher risk of cardiovascular disease (CVD) death. Long-term cardiovascular risk management is crucial alongside cancer treatment for these patients.

Area of Science:

  • Oncology
  • Cardiology
  • Geriatrics

Background:

  • Cardiovascular disease (CVD) is a critical concern in older adults.
  • Hematological malignancies (HM) are common in the elderly population.
  • The interplay between HM and CVD risk in older patients requires investigation.

Purpose of the Study:

  • To determine the risk of CVD-related death in older patients diagnosed with major hematological malignancies.
  • To compare CVD mortality in HM patients with the general older population.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Result database for 103,102 older patients with HM (1975-2018).
  • Employed Fine-Gray subdistribution hazards regression, standardized mortality ratios (SMR), and absolute excess risk (AER) for risk assessment.
  • Analyzed CVD-related death proportions and cumulative mortality over a median follow-up of 2.7 years.

Main Results:

  • CVD-related death is the second leading cause of mortality in older HM patients, following primary malignancy.
  • Older HM patients exhibited significantly higher SMR and AER for CVD, heart disease, and cerebrovascular disease compared to the general older population.
  • Specific HM types (e.g., Hodgkin lymphoma stage I/II) and patient age groups (≥85 years with chronic lymphocytic leukemia) showed CVD mortality surpassing primary malignancy over time.

Conclusions:

  • Older patients with HM face elevated long-term cardiovascular risks.
  • Integrated cardiovascular risk management is essential for older HM patients.
  • Proactive management strategies should target high-risk individuals within this demographic.
Abstract

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