Cardiovascular Risk Factors Are Associated With Future Cancer

作者：Emily S. Lau, Samantha M. Paniagua, Elizabeth Liu, Manol Jovani, Shawn X. Li, Katherine S. Takvorian, Navin Suthahar, Susan Cheng, Greta Lee Splansky, James L. Januzzi, Thomas J. Wang, Ramachandran S. Vasan, Bernard E. Kreger, Martin G. Larson, Daniel Levy, Rudolf A. de Boer, Jennifer E. Ho · 发表于：JACC CardioOncology · 年份：2021 · DOI：10.1016/j.jaccao.2020.12.003 · 被引用次数：193 · 研究领域：Cardiovascular Health and Risk Factors、Chemotherapy-induced cardiotoxicity and mitigation、Cancer, Lipids, and Metabolism

BACKGROUND: The extent to which co-occurrence of cardiovascular disease (CVD) and cancer is due to shared risk factors or other mechanisms is unknown. OBJECTIVES: We investigated the association of standard CVD risk factors, CVD biomarkers, preexisting CVD, and ideal CV health metrics with the development of future cancer. METHODS: We prospectively followed Framingham Heart Study and PREVEND participants free of cancer at baseline, and ascertained histology-proven cancer. We studied the association of baseline CV risk factors, 10-year atherosclerotic CVD risk score, established CVD biomarkers, prevalent CVD, and AHA Life's Simple 7 CV health score with incident cancer using multivariable Cox models. Analyses of interim CVD events with incident cancer used time-dependent covariates. RESULTS: Among 20,305 participants (mean age 50 ± 14 years, 54% women), 2,548 incident cancer cases occurred over a median follow-up of 15.0 (13.3-15.0) surveillance years. Traditional CVD risk factors including age, sex, and smoking status were independently associated with cancer (P <0.001 for all). Estimated 10-year atherosclerotic CVD risk was also associated with future cancer (HR 1.16 per 5% increase in risk, 95% CI 1.14-1.17, P<0.001). We found that natriuretic peptides (NP) (tertile 3 vs 1: HR 1.40, 95% CI 1.03-1.91, p=0.035) was associated with incident cancer, but not high sensitivity troponin (hs-cTn) (p=0.47). Prevalent CVD and the development of interim CV events were not associated wi...