Excess Cardiovascular Burden Among Young Patients with Cancer: A Systematic Review and Meta-Analysis
- 1University of Miami/HCA Florida JFK Hospital, Atlantis, FL 33462, USA
- 2College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
- 3Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
Abstract
Background: Young patients with cancer may develop cardiovascular complications decades earlier than the general population, yet their long-term cardiovascular risk remains incompletely defined. Most prior evidence derives from older adults or therapy-specific analyses, leaving adolescents and young adults understudied as a distinct population. Methods: We performed a systematic review and meta-analysis of observational cohort, registry-based, and population-based studies evaluating cardiovascular outcomes or mortality among young patients with cancer (adolescents and young adults [15–39 years], <45 years, <50 years, or clearly defined young age subgroups) compared with age-matched comparators. PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched from inception through 26 February 2026. Two reviewers independently screened studies and assessed risk of bias using the Newcastle–Ottawa Scale. Evidence certainty was evaluated with GRADE. Random-effects models were used for pooled analyses. Results: Fifty-eight studies were included. Young patients with cancer had significantly increased risks of heart failure (HR, 4.08; 95% CI, 2.20–7.57), pulmonary embolism (HR, 4.63; 95% CI, 3.03–7.06), venous thrombosis (HR, 4.06; 95% CI, 2.51–6.58), and cardiomyopathy (HR, 3.52; 95% CI, 2.21–5.63). Cardiovascular mortality was also elevated (SMR, 4.30; 95% CI, 3.06–6.05), although a trim-and-fill analysis resulted in an adjusted pooled SMR of 1.79 (95% CI, 1.05–3.05, p = 0.0313). Overall cardiovascular disease risk was approximately 2-fold higher, with additional increases in stroke, arrhythmia, and hypertension. Heterogeneity was high for several key outcomes (I2, overall cardiovascular disease HR 96.0%; cardiovascular mortality SMR 99.1%; heart failure HR 92.5%; venous thrombosis HR 94.1%), and evidence certainty was low for most. Conclusions: Young patients with cancer face substantially increased risks of cardiovascular disease, particularly heart failure, cardiomyopathy, and thrombotic complications. Prospective studies are needed to determine whether earlier cardiovascular surveillance improves outcomes.
Related
- Social Inequalities, Geographical Accessibility to Care, and Excess Mortality for Patients With Hematological Malignancies in France: Results From French Cancer Registries
- The Hypoxic Burden of Sleep Apnea Predicts Cardiovascular Outcomes in Patients with Heart Failure
- Fear of progression as a mediator between symptom burden and social alienation in lung cancer patients undergoing chemotherapy
- Personality Traits and Illness Acceptance in Patients with Cancer and Cardiovascular Disease: A Cross-Sectional Study from Poland
- Age-related tumor mutational burden and inflammaging: a pan-cancer multi-omics study of treatment-naïve patients
BibTeX
@article{kiyani2026excess,
title = {{Excess Cardiovascular Burden Among Young Patients with Cancer: A Systematic Review and Meta-Analysis}},
author = {Musa Kiyani and Robert J. Heins and John Hayssam Yazji and Harith Almimar and Gilberto de Lima Lopes},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213579},
url = {https://www.mdpi.com/2072-6694/18/21/3579},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Excess Cardiovascular Burden Among Young Patients with Cancer: A Systematic Review and Meta-Analysis
AU - Musa Kiyani
AU - Robert J. Heins
AU - John Hayssam Yazji
AU - Harith Almimar
AU - Gilberto de Lima Lopes
PY - 2026
DA - 2026/11/07
JO - Cancers
DO - 10.3390/cancers18213579
UR - https://www.mdpi.com/2072-6694/18/21/3579
AB - Background: Young patients with cancer may develop cardiovascular complications decades earlier than the general population, yet their long-term cardiovascular risk remains incompletely defined. Most prior evidence derives from older adults or therapy-specific analyses, leaving adolescents and young adults understudied as a distinct population. Methods: We performed a systematic review and meta-analysis of observational cohort, registry-based, and population-based studies evaluating cardiovascular outcomes or mortality among young patients with cancer (adolescents and young adults [15–39 years], <45 years, <50 years, or clearly defined young age subgroups) compared with age-matched comparators. PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched from inception through 26 February 2026. Two reviewers independently screened studies and assessed risk of bias using the Newcastle–Ottawa Scale. Evidence certainty was evaluated with GRADE. Random-effects models were used for pooled analyses. Results: Fifty-eight studies were included. Young patients with cancer had significantly increased risks of heart failure (HR, 4.08; 95% CI, 2.20–7.57), pulmonary embolism (HR, 4.63; 95% CI, 3.03–7.06), venous thrombosis (HR, 4.06; 95% CI, 2.51–6.58), and cardiomyopathy (HR, 3.52; 95% CI, 2.21–5.63). Cardiovascular mortality was also elevated (SMR, 4.30; 95% CI, 3.06–6.05), although a trim-and-fill analysis resulted in an adjusted pooled SMR of 1.79 (95% CI, 1.05–3.05, p = 0.0313). Overall cardiovascular disease risk was approximately 2-fold higher, with additional increases in stroke, arrhythmia, and hypertension. Heterogeneity was high for several key outcomes (I2, overall cardiovascular disease HR 96.0%; cardiovascular mortality SMR 99.1%; heart failure HR 92.5%; venous thrombosis HR 94.1%), and evidence certainty was low for most. Conclusions: Young patients with cancer face substantially increased risks of cardiovascular disease, particularly heart failure, cardiomyopathy, and thrombotic complications. Prospective studies are needed to determine whether earlier cardiovascular surveillance improves outcomes.
SN - 2072-6694
ER -