Increased Out-of-Hospital Cardiac Arrest Risk in Cancer: Evidence From 800,000 Patients and 3.7 Million Controls.
7 affiliations
- 1Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden. Electronic address: [email protected].
- 2Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
- 3Center for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden.
- 4Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
- 5Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden; South General Hospital, Department of Oncology, Stockholm, Sweden.
- 6Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; R&D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden; Institute for Palliative Care, Region Skåne Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- 7Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Abstract
Background
Although cancer patients face an increased risk of cardiovascular disease, their risk of out-of-hospital cardiac arrest (OHCA) remains poorly characterized.Objectives
The objective of the study was to investigate the hazard of OHCA among patients with cancer and identify clinical factors associated with increased hazard compared with cancer-free controls.Methods
This population-based, matched cohort study included adults (≥18 years) diagnosed with cancer from 2010 to 2022, matched 1:5 on age, sex, and region, to cancer-free controls. Using 7 national registers, we assessed the hazard of OHCA for all cancers combined and across subgroups, including cancer site, metastasis status, and cardiovascular risk factors, using Cox proportional hazards models and model-based estimates of cumulative incidence.Results
A total of nearly 800,000 patients with cancer and 3,700,000 controls were included. Cancer was associated with a 55% higher hazard of OHCA (adjusted HR: 1.55; 95% CI: 1.50-1.60), than controls. The greatest excess hazards were observed in lung, gastrointestinal, and neurological cancers. The association was strongest within the first year after cancer diagnosis, but remained increased throughout follow-up. Lung and neurological cancers were associated with the greatest short-term hazards, approximately 6-fold higher than controls, whereas lung cancer and multiple myeloma showed the highest long-term excess hazards, approximately 2- to 3-fold higher.Conclusions
Patients with cancer had a higher hazard of OHCA than cancer-free controls. Cancer site, time since diagnosis, and metastasis status were key factors associated with the hazard of OHCA. These findings may help inform tailored cardiovascular risk assessment, preventive strategies, shared decision-making, and end-of-life planning in oncology care.
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BibTeX
@article{hagglund2026increased,
title = {{Increased Out-of-Hospital Cardiac Arrest Risk in Cancer: Evidence From 800,000 Patients and 3.7 Million Controls.}},
author = {Hanna L Hägglund and Agneta Månsson Broberg and Martin Jonsson and Sandra Eloranta and Elham Hedayati and Christel Hedman and Therese Djärv},
journal = {JACC. Advances},
year = {2026},
month = oct,
doi = {10.1016/j.jacadv.2026.103293},
url = {https://europepmc.org/article/MED/42832921},
note = {CC BY},
}
RIS
TY - JOUR
TI - Increased Out-of-Hospital Cardiac Arrest Risk in Cancer: Evidence From 800,000 Patients and 3.7 Million Controls.
AU - Hanna L Hägglund
AU - Agneta Månsson Broberg
AU - Martin Jonsson
AU - Sandra Eloranta
AU - Elham Hedayati
AU - Christel Hedman
AU - Therese Djärv
PY - 2026
DA - 2026/10/05
JO - JACC. Advances
DO - 10.1016/j.jacadv.2026.103293
UR - https://europepmc.org/article/MED/42832921
AB - Background Although cancer patients face an increased risk of cardiovascular disease, their risk of out-of-hospital cardiac arrest (OHCA) remains poorly characterized.Objectives The objective of the study was to investigate the hazard of OHCA among patients with cancer and identify clinical factors associated with increased hazard compared with cancer-free controls.Methods This population-based, matched cohort study included adults (≥18 years) diagnosed with cancer from 2010 to 2022, matched 1:5 on age, sex, and region, to cancer-free controls. Using 7 national registers, we assessed the hazard of OHCA for all cancers combined and across subgroups, including cancer site, metastasis status, and cardiovascular risk factors, using Cox proportional hazards models and model-based estimates of cumulative incidence.Results A total of nearly 800,000 patients with cancer and 3,700,000 controls were included. Cancer was associated with a 55% higher hazard of OHCA (adjusted HR: 1.55; 95% CI: 1.50-1.60), than controls. The greatest excess hazards were observed in lung, gastrointestinal, and neurological cancers. The association was strongest within the first year after cancer diagnosis, but remained increased throughout follow-up. Lung and neurological cancers were associated with the greatest short-term hazards, approximately 6-fold higher than controls, whereas lung cancer and multiple myeloma showed the highest long-term excess hazards, approximately 2- to 3-fold higher.Conclusions Patients with cancer had a higher hazard of OHCA than cancer-free controls. Cancer site, time since diagnosis, and metastasis status were key factors associated with the hazard of OHCA. These findings may help inform tailored cardiovascular risk assessment, preventive strategies, shared decision-making, and end-of-life planning in oncology care.
SN - 2772-963X
ER -