Better treatments have led to improved cancer survival rates, but new research reveals increased cardiovascular complications in survivors. However, another new study offers hope, suggesting that heart medications like SGLT2 inhibitors may help prevent cancer-related heart disease.
A new Cancer Journal study showed that older cancer survivors have far higher rates of cardiovascular events than their peers who never had cancer. The study analyzed 15,454 ASPREE trial participants (all ≥65yrs) who had no history of cancer, including 1,392 (9%) participants who were later diagnosed with cancer and didn’t have a history of CVD.
- Those cancer survivors proved two-times more likely to develop CVD than participants who never had cancer (21 vs. 10 events per 1k person years).
- Patients treated with chemotherapy had two-times higher CVD incidence, while surgically-treated patients had 56% lower CVD rates.
- CVD risk was greatest soon after cancer diagnosis (potentially due to chemo), and remained elevated across the 4-year follow-up period.
The authors attributed cancer’s CVD risks to a range of factors, including chemotherapy’s already-established CVD risks, but also the two diseases’ shared risk factors (e.g. smoking) and cancer-induced risk factors (e.g. inflammation). They also called for more efforts to expand cardiovascular screening and management efforts among cancer patients.
Another well-timed JACC study suggests that SGLT2 inhibitors could help mitigate cancer treatments’ cardiovascular risks. The study retrospectively analyzed 17,350 cancer patients with type 2 diabetes undergoing chemotherapy with cardio-toxic effects, half of whom were taking SGLT2 inhibitors.
- The SGLT2i-treated patients had a 24% lower risk of developing cancer therapy-related cardiac dysfunction, and a 19% reduction in heart failure exacerbations.
- The SGLT2i group also had 33% lower risk of all-cause mortality and 7% lower risk of all-cause hospitalizations or ED visits.
- A subgroup analysis also showed that SGLT2i patients had lower risk of cancer therapy–related cardiac dysfunction across the various classes of cancer therapies.
The Takeaway
The fact that a cancer diagnosis is often followed by cardiovascular events is one of the many harsh realities of the disease, but this new JAMA study suggests that some heart meds might be able to prevent cancer’s cardiovascular risks. More research is needed before we see increased use of preventative CVD meds among cancer patients, but studies like these seem like a solid first step.
