Risk of coronary heart disease in patients with cancer: A nationwide follow-up study from Sweden

Background: Risk of coronary heart disease (CHD) in cancer patients has not been thoroughly investigated. The aim of the present study was to examine whether there is an association between cancer and first hospitalisation for CHD. Methods: All individuals in Sweden with a diagnosis of cancer between 1st January 1987 and 31st December 2008 were followed for first hospitalisation for CHD. The reference population was the total population of Sweden without cancer. Standardised incidence ratios (SIRs) for CHD were calculated. Results: The overall CHD risk during the first 6 months after diagnosis of cancer was 1.70 (95% confidence interval (95% CI) 1.66-1.75). For 26 of the 34 cancers studied, the risk of CHD was increased during the first 6 months after diagnosis of cancer. The overall CHD risk decreased rapidly, but remained slightly elevated, even 10+ years after diagnosis of cancer (SIR 1.07; 95% CI 1.04-1.11). The cancer sites/types for which risk of CHD was highest during the first 6 months were small intestine (SIR 2.88; 95% CI 2.02-3.99), leukaemia (SIR 2.84; 95% CI 2.37-3.37), kidney (SIR 2.65; 95% CI 2.30-3.04), lung (SIR 2.56; 95% CI 2.35-2.80) and liver (SIR 2.28; 95% CI 1.91-2.71). Metastases were associated with an increased risk of CHD (SIR 1.46; 95% CI 1.28-1.65). Interpretation: Most cancers were associated with an increased risk of CHD during the first 6 months after diagnosis. CHD risk was related to the presence of metastates. Cancer patients may need a more aggressive treatment of classical CHD risk factors. (C) 2011 Elsevier Ltd. All rights reserved.