Research Paper Volume 11, Issue 18 pp 7948—7960

Prevalence and prognosis significance of cardiovascular disease in cancer patients: a population-based study

Dong Liu1, *, , Zhiqiang Ma2, *, , Jingang Yang1, , Min Zhao3, , Huiping Ao4, , Xiaodong Zheng5, , Qianfa Wen6, , Yuejin Yang1, , Jiangyun You7, , Shubin Qiao1, , Jiansong Yuan1, ,

  • 1 State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
  • 2 Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an 710038, China
  • 3 Yunnan Cancer Hospital, Kunming 650221, China
  • 4 Jiangxi Cancer Hospital, Nanchang 330029, China
  • 5 Chongqing Cancer Hospital, Chongqing 400030, China
  • 6 Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
  • 7 Guang’anmen Hospital of Traditional Chinese Medicine, Beijing 100053, China
* Equal contribution

Received: July 8, 2019       Accepted: September 15, 2019       Published: September 27, 2019
How to Cite

Copyright © 2019 Liu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Cardiovascular disease (CVD) is a heavy burden on cancer patients worldwide. This study aimed to evaluate the prevalence and influence of cardiovascular risk factors (CVRF) and CVD on the all-cause mortality among Chinese cancer patients.

Results: Overall, 13.0% of all cancer patients had at least one type of CVRFs and 5.0% with CVDs. Patients with CVRF or CVD presented more frequently at later stages and received higher percentage of oncotherapy. During 1,782,527 person-years of follow-up, the all-cause mortality in cancer patients with CVDs and with CVRFs was higher compared with those without (182.6/1000, 109.5/1000 and 93.3/1000 person-years, respectively). Cox regression analysis showed that patients with heart failure (HR 1.79, 95% CI 1.61-1.99), myocardial infarction (HR 1.50, 95% CI 1.16-1.95), atrial fibrillation (HR 1.30, 95% CI 1.09-1.53), stroke (HR 1.21, 95% CI 1.11-1.32), hypertension (HR 1.10, 95% CI 1.04-1.16) and diabetes (HR 1.16, 95% CI 1.08-1.24) had increased all-cause mortality, whereas dyslipidemia patients had better prognosis (HR 0.73, 95% CI 0.64-0.83). Stratified by cancer type, the prognostic impact of specific CVRF or CVD varied.

Methods: We consecutively recruited 710,170 cancer patients between Feb. 1995 and Jun. 2018. A stratified Cox proportional hazards model was used to analyze the effect of comorbidities on the overall survival of patients stratified by cancer type.

Conclusions: Cancer patients are vulnerable to comorbidity related to heart and cerebral disease. The influence of comorbidities on prognosis is noticeable and specific both for the type of cancer and comorbidities.


CVD: cardiovascular disease; CVRF: cardiovascular risk factors; AF: atrial fibrillation; HF: heart failure; ANOVA: an analysis of variance; HRs: Hazards ratio; 95% CI: 95% confidence interval; ADT: androgen deprivation therapy; TC: total cholesterol.