Cancer patients at risk of heart disease death after surgery

Patients who underwent primary cancer site surgery are at greater risk of death from heart disease than the general population, reports a US study.

A total of 1,390,585 cancer patients underwent primary surgical resection from 2000 to 2020. Of these, 178,303 (12.8 percent) died of heart disease.

The standardized mortality ratio (SMR) of heart disease postsurgery was 6.85 (95 percent confidence interval, 6.82‒6.88; p<0.001). The highest SMRs were observed in cancers of the brain and other nervous system, oesophagus, liver and intrahepatic bile duct, pancreas, and lung and bronchus.

Nearly half of all heart disease deaths occurred within the first 5 years after surgery for all cancers, with risk factors such as male sex, older age, Black race, unmarried status, and rurality.

“These findings can be used to guide surgical planning and follow-up strategies,” the investigators said.

This retrospective population-based study identified cancer patients who underwent primary surgical resection from 2000 to 2020 using the Surveillance, Epidemiology, and End Results database.

The investigators assessed the incidence of heart disease mortality following primary cancer site surgery using SMRs and described the timing of heart disease mortality after surgery. They also identified risk factors using Fine and Gray competing risk analysis.

“Patients with cancer may be at higher risk of heart disease from anticancer therapies,” the investigators said. “However, there is limited data on the risks of heart disease mortality after primary cancer site surgery.”