Cardiovascular disease and stroke following cancer and cancer treatment in older adult: secondary analysis of the randomized ASPREE study

Cancer survivors can be at risk of cardiovascular disease (CVD) because of their malignancy and/or its treatment. The ASPREE study in Australia and the United States randomized individuals aged 70 years or older (65 year or for US ethnic minorities) to low-dose aspirin (100 mg daily) or placebo. Secondary analysis of the study investigated the impact of cancer and cancer treatment on a composite CVD endpoint comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke. Among 15,454 ASPREE participants, 1392 (9%) had an incident cancer diagnosis. Rates of CVD were greater in the cancer risk-set compared to the cancer-free risk-set (20.8 versus 10.3 events per 1000 person-years; IRR 2.03; 95% CI 1.51-2.66). Increased incidence remained after correction for clinically significant risk factors for CVD. Similar rates of CVD were seen across aspirin and placebo groups. The authors conclude that incidence of CVD was increased in older adults with cancer.