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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardio-Oncology
Volume 11 - 2024 |
doi: 10.3389/fcvm.2024.1393631
Cardiovascular Disease in Thymic Cancer Patients
Provisionally accepted- 1 Division of Pediatric Cardiology, Department of Pediatrics, School of Medicine, Indiana University Bloomington, Indianapolis, Indiana, United States
- 2 Melvin and Bren Simon Comprehensive Cancer Center, Department of Medicine, School of Medicine, Indiana University Bloomington, Indianapolis, Indiana, United States
- 3 Regenstrief Institute, School of Medicine, Indiana University Bloomington, Indianapolis, United States
- 4 School of Public Health, Indiana University Bloomington, Bloomington, Indiana, United States
- 5 Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, United States
- 6 Heart and Vascular Institute, OhioHealth Systems, Columbus, United States
- 7 Center for Biomedical Informatics, Regenstrief Institute, School of Medicine, Indiana University Bloomington, Indianapolis, United States
- 8 Division of General Internal Medicine and Geriatrics, Department of Medicine, School of Medicine, Indiana University Bloomington, Indianapolis, United States
Cancer patients may have increased risk for adverse cardiac events, but our understanding of cardiovascular risk in thymic cancer patients is not clear. We sought to characterize baseline cardiometabolic risk factors before thymic cancer diagnosis and the potential association between cancer treatment and subsequent cardiac events.This was a retrospective cohort study evaluating patients with thymic cancer from 2003 to 2020 compared to age-and sex-matched controls without cancer. Baseline cardiovascular risk factors, cancer characteristics, and incidence of cardiac events were collected from the health information exchange. Multivariable regression was used to examine the impact of cardiovascular risk factors and cancer therapies.We compared 296 patients with pathology-confirmed thymic cancer to 2,960 noncancer controls. Prior to cancer diagnosis, thymic cancer patients (TCPs) had lower prevalence of hypertension, dyslipidemia, and diabetes mellitus and similar rates of obesity, tobacco use, and pre-existing cardiovascular disease (CVD) compared to controls. After diagnosis, high-risk TCPs (>2 cardiovascular risk factors or pre-existing CVD) had higher risk for cardiac events (HR 3.73, 95% CI 2.88-4.83, p<0.001). In the first 3 years after diagnosis, TCPs had higher incidence of cardiac events (HR 1.38, 95% CI 1.01-1.87, p=0.042). High-risk TCPs who received radiotherapy or chemotherapy had higher risk of cardiac events (HR 4.99, 95% CI 2.30-10.81, p<0.001; HR 6.24, 95% CI 2.84-13.72, p<0.001).Compared to noncancer controls, TCPs experienced more cardiac events when adjusted for risk factors. Patients with multiple cardiovascular risk factors receiving radiotherapy or chemotherapy had higher incidence of cardiac events.
Keywords: Thymic cancer, cancer survivorship, cardiovascular disease, Electronic Health Records, thoracic oncology, cardiovascular risk factors
Received: 29 Feb 2024; Accepted: 26 Aug 2024.
Copyright: © 2024 Khemka, Clasen, Loehrer, Roberts, Golzarri-Arroyo, Badve, Raman, Hui and Schleyer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Abhishek Khemka, Division of Pediatric Cardiology, Department of Pediatrics, School of Medicine, Indiana University Bloomington, Indianapolis, Indiana, United States
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