Gynecologic oncology · 2026
Cardiovascular outcomes in individuals with ovarian cancer: A retrospective cohort study.
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AlAshqar Abdelrahman, Clark Mitchell, Gross Cary P, Spatz Erica S, Xu Xiao
Аннотация
OBJECTIVE: To examine the association between ovarian cancer and subsequent risk of cardiovascular disease (CVD).
METHODS: This retrospective cohort study used deidentified claims data from the Optum Labs Data Warehouse with linked Surveillance, Epidemiology, and End Results (SEER) data. Female patients aged ≥18 with ovarian cancer (2010-2021) who underwent bilateral oophorectomy were propensity score-matched to non-cancer controls who had bilateral oophorectomy for benign indications based on age, cardiovascular risk factors, comorbidities, and oophorectomy year. Outcome measure was incident major adverse cardiovascular events (MACE), a composite of angina, acute myocardial infarction, heart failure, stroke, transient ischemic attack, cardiac arrest, or cardiovascular procedures. Time to first MACE was compared between ovarian cancer and non-cancer patients using Gray's tests and Fine-Gray sub-distribution hazard models accounting for death as a competing risk.
RESULTS: A total of 1148 ovarian cancer patients were matched to 2284 non-cancer controls. Median (interquartile range) follow-up was 29 (13-54) months for ovarian cancer patients and 40 (17-70) months for controls. One-, two-, three-, and five-year MACE risks were higher in ovarian cancer patients (7.7%, 12.0%, 17.1%, 24.8%) compared to controls (5.3%, 9.1%, 12.9%, 18.6%). Ovarian cancer was associated with increased MACE risk (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.14-1.56), with a more pronounced association in patients <55 years (HR 1.95, 95% CI 1.01-3.58) than ≥55 years (HR 1.30, 95% CI 1.09-1.53).
CONCLUSION: Ovarian cancer is associated with increased CVD risk, particularly among younger patients, calling for mechanistic studies elucidating this relationship.
METHODS: This retrospective cohort study used deidentified claims data from the Optum Labs Data Warehouse with linked Surveillance, Epidemiology, and End Results (SEER) data. Female patients aged ≥18 with ovarian cancer (2010-2021) who underwent bilateral oophorectomy were propensity score-matched to non-cancer controls who had bilateral oophorectomy for benign indications based on age, cardiovascular risk factors, comorbidities, and oophorectomy year. Outcome measure was incident major adverse cardiovascular events (MACE), a composite of angina, acute myocardial infarction, heart failure, stroke, transient ischemic attack, cardiac arrest, or cardiovascular procedures. Time to first MACE was compared between ovarian cancer and non-cancer patients using Gray's tests and Fine-Gray sub-distribution hazard models accounting for death as a competing risk.
RESULTS: A total of 1148 ovarian cancer patients were matched to 2284 non-cancer controls. Median (interquartile range) follow-up was 29 (13-54) months for ovarian cancer patients and 40 (17-70) months for controls. One-, two-, three-, and five-year MACE risks were higher in ovarian cancer patients (7.7%, 12.0%, 17.1%, 24.8%) compared to controls (5.3%, 9.1%, 12.9%, 18.6%). Ovarian cancer was associated with increased MACE risk (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.14-1.56), with a more pronounced association in patients <55 years (HR 1.95, 95% CI 1.01-3.58) than ≥55 years (HR 1.30, 95% CI 1.09-1.53).
CONCLUSION: Ovarian cancer is associated with increased CVD risk, particularly among younger patients, calling for mechanistic studies elucidating this relationship.