Cancer survivorship and subclinical myocardial damage

Roberta Florido, Alexandra K. Lee, John W. McEvoy, Ron C. Hoogeveen, Silvia Koton, Mara Z. Vitolins, Chetan Shenoy, Stuart D. Russell, Roger S. Blumenthal, Chiadi E. Ndumele, Christie M. Ballantyne, Corinne E. Joshu, Elizabeth A. Platz, Elizabeth Selvin

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Cancer survivors might have an excess risk of cardiovascular disease (CVD) resulting from toxicities of cancer therapies and a high burden of CVD risk factors. We sought to evaluate the association of cancer survivorship with subclinical myocardial damage, as assessed by elevated high-sensitivity cardiac troponin T (hs-cTnT) test results. We included 3,512 participants of the Atherosclerosis Risk in Communities Study who attended visit 5 (2011-2013) and were free of CVD (coronary heart disease, heart failure, or stroke). We used multivariate logistic regression to evaluate the cross-sectional associations of survivorship from any, non-sex-related, and sex-related cancers (e.g., breast, prostate) with elevated hs-cTnT (≥14 ng/L). Of 3,512 participants (mean age, 76 years; 62% women; 21% black), 19% were cancer survivors. Cancer survivors had significantly higher odds of elevated hs-cTnT (OR = 1.26, 95% CI: 1.03, 1.53). Results were similar for survivors of non-sex-related and colorectal cancers, but there was no association between survivorship from breast and prostate cancers and elevated hs-cTnT. Results were similar after additional adjustments for CVD risk factors. Survivors of some cancers might be more likely to have elevated hs-cTnT than persons without prior cancer. The excess burden of subclinical myocardial damage in this population might not be fully explained by traditional CVD risk factors.

Original languageEnglish (US)
Pages (from-to)2188-2195
Number of pages8
JournalAmerican journal of epidemiology
Issue number12
StatePublished - Dec 31 2019

Bibliographical note

Funding Information:
E.S. was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (grants K24DK106414 and R01DK089174). E.S. and C.M.B. were supported by the National Heart, Lung, and Blood Institute (grant R01HL134320). A.K.L. was supported by the National Heart, Lung, and Blood Institute (grant T32HL007024). The Atherosclerosis Risk in Communities study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services (contracts HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I). Studies on cancer in the Atherosclerosis Risk in Communities Study are also supported by the National Cancer Institute (grant U01CA164975). This research was additionally supported by a Cancer Center Support Grant from the National Cancer Institute (grant P30 CA006973).

Funding Information:
We thank the staff and participants of the Atherosclerosis Risk in Communities Study for their contributions. Cancer incidence data have been provided by the Maryland Cancer Registry, Center for Cancer Surveillance and Control, Maryland Department of Health. We acknowledge the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries of the Centers for Disease Control and Prevention for the funds that helped support the availability of the cancer registry data.

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:


  • ARIC
  • biomarkers
  • cancer
  • cardiovascular disease
  • hs-cTnT

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.


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