EFFECTS OF CARDIOPULMONARY STRESS FROM CANCER AND ASSOCIATED TREATMENT ON CARDIOVASCULAR RISK SCORE IN CARDIAC PATIENTS: A PILOT STUDY

Abstract

Therapeutic Area

ASCVD/CVD in Special Populations

Background

The predicting risk of cardiovascular disease EVENTs (PREVENT) score has become a widely used tool to assess cardiovascular disease (CVD) risk. The improved calibration and inclusion of additional clinical and social variables make for comprehensive cardiac risk assessments compared to the atherosclerotic cardiovascular disease 2013 risk estimator (ASCVD). Studies have shown an increased incidence of atherosclerotic cardiovascular disease and heart failure in patients who are cancer survivors. However, no comparative studies have evaluated PREVENT and ASCVD risk scores in patients with a history of cancer.

Methods

A six-year retrospective analysis (2019-2025) was performed using the Long Island Heart Rhythm Center electronic medical records. Patients were selected by keyword search including “malignancy,” “cancer,” and “neoplasm.” Patients with a history of cancer were then age and sex-matched to controls. PREVENT and ASCVD scores were calculated based on American Heart Association criteria. Statistical comparison was performed utilizing a paired t-test; p0.05 was statistically significant.

Results

21 patients with oncologic diagnoses were identified, of which 5 were included (23.8%) based on data availability in their medical charts, along with age and sex-matched controls (n=5). Patient characteristics included a mean age of 63.85.9 years; M/F 0 [0%]/5 [100%]. Neoplasias identified included breast (1), lung (1), colon (1), pituitary (1), and thyroid (1). PREVENT scores for 10-year total CVD risk were 8.41% and 4.52% for cancer patients and controls, respectively (p=0.19). PREVENT scores for 30-year total CVD risk were 29.79% and 18.77% for cancer patients and controls, respectively (p=0.28). The 10-year ASCVD scores were 7.94% and 9.94% for patients with a history of cancer and controls, respectively (p=0.039).

Conclusions

This study demonstrated a dichotomy in results when comparing the PREVENT risk assessment to the ASCVD risk assessment in the same-aged population. Specifically, the PREVENT score was higher in patients with oncologic disorders as compared to controls. However, the ASCVD scores were lowered in those with a history of cancer. This study is limited due to its small sample size and retrospective design. A larger multicenter prospective study is needed in the future.