Atherosclerosis · 2026
Bidirectional association between breast cancer and cardiovascular disease: Longitudinal analysis of UK Biobank data.
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Liu Zijia, Du Fengjun, Zhao Chunhua, Xu Chunxiao, Fu Zhentao, Fan Yongna, Zhang Bingyin, Huang Xinhai, Lu Zilong, Jiang Fan, Huang Yueqing, Guo Xiaolei, Ma Jixiang
Аннотация
BACKGROUND AND AIMS: Breast cancer (BC) and cardiovascular disease (CVD) are leading causes of death in women. However, their bidirectional relationship and key risk factors remain unclear.
METHODS: This matched, prospective cohort study using UK Biobank data evaluated the association between BC and CVD, constructing two propensity-score-matched cohorts: 5318 women with BC and 36,857 with CVD, each 1:1 matched to women without the condition (total n = 10,636 and 73,714). Primary outcomes were incident CVD in the BC cohort, incident BC in the CVD cohort, and all-cause mortality in both cohorts. Cox proportional hazards, subgroup analyses, and multi-state models were used to examine the relationship between the two diseases and their stage-specific risks.
RESULTS: The mean age was 58.5 years in the BC cohort and 59.3 years in the CVD cohort, with median follow-up of 12.8 and 13.6 years. BC survivors had a higher risk of CVD (HR = 1.238, 95% CI: 1.205 to 1.273), especially atrial fibrillation and heart failure, while ischemic heart disease and myocardial infarction risks were lower. Conversely, CVD patients had a higher BC risk (HR = 1.446, 95% CI: 1.332 to 1.570). CRP and central obesity were consistent bidirectional risk factors, while BMI, lifestyle, socioeconomic status, and medication use had stage-specific effects.
CONCLUSIONS: This study provides longitudinal evidence for a bidirectional relationship between BC and CVD, with transition probabilities significantly modulated by stage-specific risk profiles.
METHODS: This matched, prospective cohort study using UK Biobank data evaluated the association between BC and CVD, constructing two propensity-score-matched cohorts: 5318 women with BC and 36,857 with CVD, each 1:1 matched to women without the condition (total n = 10,636 and 73,714). Primary outcomes were incident CVD in the BC cohort, incident BC in the CVD cohort, and all-cause mortality in both cohorts. Cox proportional hazards, subgroup analyses, and multi-state models were used to examine the relationship between the two diseases and their stage-specific risks.
RESULTS: The mean age was 58.5 years in the BC cohort and 59.3 years in the CVD cohort, with median follow-up of 12.8 and 13.6 years. BC survivors had a higher risk of CVD (HR = 1.238, 95% CI: 1.205 to 1.273), especially atrial fibrillation and heart failure, while ischemic heart disease and myocardial infarction risks were lower. Conversely, CVD patients had a higher BC risk (HR = 1.446, 95% CI: 1.332 to 1.570). CRP and central obesity were consistent bidirectional risk factors, while BMI, lifestyle, socioeconomic status, and medication use had stage-specific effects.
CONCLUSIONS: This study provides longitudinal evidence for a bidirectional relationship between BC and CVD, with transition probabilities significantly modulated by stage-specific risk profiles.