A large-scale population-based cohort study from Amsterdam UMC, recently published in the Journal of the American College of Cardiology (JACC), highlights significantly increased cardiovascular disease (CVD) risk among adults diagnosed with hematological malignancies. The research, conducted in collaboration with the ‘Netherlands Comprehensive Cancer Organisation’ (IKNL) and UMC Utrecht, analyzed data from nearly 175,000 patients and over 855,000 controls.
Study Design and Scope
The research team examined records from the Netherlands Cancer Registry, focusing on patients diagnosed between 1995 and 2023. Eleven cardiovascular outcomes, including heart failure, stroke, and venous thromboembolism, were evaluated across twelve blood and lymphatic cancer types.
Key Findings
Heart failure risk was elevated across all cancer subtypes, with the highest excess rates observed in myelodysplastic syndrome and multiple myeloma. Venous thromboembolism risk peaked in the first year after diagnosis, especially in Hodgkin lymphoma, where the risk was over thirty times higher than in the general population.
Clinical Implications
“These findings underscore the urgent need for tailored cardiovascular surveillance in cancer patients and survivors,” says Jesse Geels, first author and PhD candidate at Amsterdam UMC. “Cancer therapies are becoming increasingly effective, yet the cardiovascular consequences of both the disease and its treatment is often unpredictable and can affect quality of life even well beyond the point of cure.” The results address a gap identified in a companion analysis by the same group published in The BMJ. In that systematic review, PhD candidate Clara Gomes evaluated all prediction models for cancer therapy-related cardiac damage published to date, finding the large majority were developed exclusively for adults with breast cancer, leaving patients with haematological malignancies largely underrepresented. The present study provides the large-scale epidemiological foundation needed to begin closing that gap.
Future Directions
The international recognition of these two studies has led to new funding for follow-up research. Amsterdam UMC researchers recently received a €600,000 grant as part of the COMPASS consortium, supported by the Innovative Health Initiative (IHI) of the European Union. “Our goal is to develop and validate robust risk prediction models using advanced biomarkers and AI. By combining expertise and technology, we can truly make a difference for patients facing both cancer and heart disease.” explains Prof. Folkert Asselbergs, co-investigator. “This will allow us to identify patients at highest risk earlier and improve outcomes through personalized care.”
Towards Integrated Care
“Cardiology and oncology are increasingly intertwined disciplines, a reality that demands structural collaboration rather than ad hoc consultation” emphasizes Marijke Linschoten, cardiology resident and principal investigator. With innovative tools and international partnerships, the Amsterdam UMC cardio-oncology team aims to establish evidence-based frameworks for cardiovascular risk management across the full spectrum of cancer patients. “Complementary analyses examining cardiovascular outcomes in patients with solid malignancies are currently underway”, Linschoten adds.