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Risk analysis of cardiovascular mortality after gastric cancer diagnosis: a large population-based study

Qiang Zhao1, Qiaohong Zhou2, Jiayue Dong3

  • 1Department of Cardiology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China.

Frontiers in Cardiovascular Medicine
|May 7, 2025
PubMed

Insights

Cardiovascular disease (CVD) mortality is increasing in gastric cancer (GC) survivors. This study identified age, cancer stage, surgery, and radiotherapy as key predictors of CVD death in GC patients, informing long-term care strategies.

Area of Science:

  • Cardio-oncology
  • Cancer epidemiology
  • Public health

Background:

  • Cancer survivors face increasing risks of cardiovascular mortality.
  • Gastric cancer (GC) survivors are a population of concern for cardiovascular disease (CVD) development.
  • Understanding CVD-specific mortality trends and risk factors in GC patients is crucial for improved survivorship care.

Purpose of the Study:

  • To investigate the dynamic trends of cardiovascular death in gastric cancer patients.
  • To identify prognostic risk factors for cardiovascular disease-specific mortality in non-metastatic gastric cancer patients.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) database to collect data on 29,324 primary gastric cancer patients.
  • Calculated age-, gender-, calendar year-, and race-adjusted standardized mortality ratios (SMRs).
  • Employed Fine-Gray's competing risk models to identify prognostic factors for cardiovascular death.

Main Results:

  • Cardiovascular deaths occurred in 5.2% of local/regional GC patients and 0.9% of metastatic GC patients.
  • Standardized mortality ratios for CVD-specific mortality showed a continuous increase from the 1970s to the 2010s.
  • Key predictors of CVD-specific mortality included older age (>75 years), advanced T and N stages, undergoing surgery, and radiotherapy.

Conclusions:

  • This study elucidates the evolving trend of cardiovascular death among gastric cancer patients.
  • Identified significant prognostic predictors for cardiovascular mortality, emphasizing the need for integrated cardio-oncology care.
  • A nomogram was developed to predict CVD-specific mortality risk in local/regional gastric cancer patients, aiding in tailored follow-up.
Abstract

Keywords:
cardio-oncology teamscardiovascular mortalitycompeting risk modelsgastric cancerrisk predictor

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