A new study from VCU Massey Comprehensive Cancer Center and VCU Health Pauley Heart Center shows that survivors of childhood cancer have a significantly higher risk of death after a major cardiovascular event. including heart failure, heart attack, and stroke -; than in the general population.

The survey results will be released this week. Journal of the American College of Cardiology -; This may facilitate support for a paradigm shift in clinical heart health guidelines to address cardiovascular risk factors early in childhood cancer survivors.

We found that the risk of death after a major cardiovascular event at age 50 in the general population is similar to the risk of death at age 30 after being treated for cancer as a child. Untreated risk factors have a greater impact on the risk of death after serious cardiac events in childhood cancer survivors compared to the general population. Therefore, one should not simply assume that risk factors such as hyperemia are unnecessary because one is young. Are you being treated for blood pressure or high cholesterol? ”

Wendy Bottiner, MD, lead study author and cardio-oncologist at Massey & Pauley Heart Center

Previous studies have demonstrated that childhood cancer survivors have a higher risk of heart disease and higher rates of death from cardiovascular disease than the general population.

This study improved our understanding of the impact of childhood cancer on the subsequent mortality risk of survivors after a major cardiovascular event compared to those who have never had cancer but have experienced the same heart disease. .

Bottiner and his collaborators turned to several powerful databases for answers. These include the Childhood Cancer Survivor Study, which includes a large cohort of 25,000 childhood cancer survivors and their siblings, and the CARDIA Study, an ethnically diverse youth heart disease database. A program for adults designed to gain insight into how people develop heart disease.

They found that the risk of death after heart failure, heart attack, or stroke was higher for childhood cancer survivors than for their siblings without cancer. Surprisingly, compared to the general population, these childhood cancer survivors were more than 10 years younger at the time he experienced any of the three events.

“This study supports the concept that childhood cancer survivors experience symptoms such as accelerated aging and have an overall medical profile similar to those 10 years older.” said Bottiner, who is also a member of the Cancer Prevention and Control Association. Research Program at Massey.

In an effort to identify some potential solutions, researchers have identified a medical condition known as dyslipidemia. This can lead to an imbalance of cholesterol and fats in the blood, which can lead to clogged arteries and serious heart disease. Correlated with reduced mortality after cardiovascular events. Statins are commonly prescribed to people diagnosed with dyslipidemia. Statins reduce the risk of heart complications by lowering cholesterol levels and reducing chronic inflammation, which is a known risk factor for both heart disease and cancer. Evidence so far suggests that statins may be heart-protective drugs in patients undergoing cancer treatment.

This led Dr. Bottiner and his colleagues to use statins more widely in childhood cancer survivors, not just populations with heart disease, to reduce mortality after cardiovascular complications later in life. suggested that a general and enhanced protective effect on rates may be obtained.

Additionally, this paper shows that hypertension -; Elevated blood pressure – also associated with increased risk of heart-related death in childhood cancer survivors. Previously published data shows that people who have been treated for cancer and have high blood pressure have an increased risk of heart disease compared to people who have high blood pressure but are not treated for cancer.

Bottiner said current guidelines from multiple medical associations often include high thresholds for who qualifies for blood pressure treatment, especially for younger patients, who are at higher risk of long-term cardiac complications. He stated that these parameters need to be adjusted to alleviate this.

“When we’re talking about childhood cancer survivors, their risk for heart disease is much higher than the general population, so perhaps we need to lower the bar for high blood pressure treatment,” Bottiner said.

Looking ahead, Bottiner said more research is needed to better understand the burden of heart health risk factors in young adults treated for cancer. Clinical trials should be initiated to investigate whether modifying risk factors affects patient outcomes. And efforts need to be undertaken to increase public awareness of risk factors that occur after cancer treatment in children and young adults.

The emerging field of cardio-oncology is paving the way for expert multidisciplinary cardiac care before, during, and after cancer treatment to reduce the negative effects on cardiovascular health. The Massey and Pauley Heart Center’s Cardio-Oncology Program is the only program in Virginia to be recognized as a Center of Excellence by the International Society of Cardio-Oncology.

Co-investigators on Dr. Bottiner’s study include Eric Chou, MD, MPH, and David Doody, MS, of the Fred Hutchinson Cancer Center. Dr. Cindy Im and Dr. David Jacobs Jr. of the University of Minnesota; Salo Armenian, DO, MPH, City of Hope. Alexander Alintin, MD, University of Alabama; Dr. Bora Hong of Seattle Children’s Hospital. Dr. Rebecca Howell of MD Anderson Cancer Center; Gregory Armstrong, M.D., Kirsten Ness, M.D., and Yutaka Yasui, M.D., of St. Jude Children’s Research Hospital; Kevin Offinger, MD, Duke University; Alexander Reiner, MD, MSc, University of Washington;