Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients
Background: Cardiovascular disease is a major non-cancer cause of morbidity in cancer patients. Low-density lipoprotein cholesterol (LDL) and hemoglobin A1C (HbA1C) are shared risk factors for cancer and cardiovascular disease. However, optimal management for these factors in cancer patients remains...
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Elsevier
2025-09-01
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| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487525001060 |
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| author | Yen-Chou Chen Jhih-Yuan Lu Chun-Yao Huang Yu-Hsuan Joni Shao |
| author_facet | Yen-Chou Chen Jhih-Yuan Lu Chun-Yao Huang Yu-Hsuan Joni Shao |
| author_sort | Yen-Chou Chen |
| collection | DOAJ |
| description | Background: Cardiovascular disease is a major non-cancer cause of morbidity in cancer patients. Low-density lipoprotein cholesterol (LDL) and hemoglobin A1C (HbA1C) are shared risk factors for cancer and cardiovascular disease. However, optimal management for these factors in cancer patients remains unclear. Methods: This retrospective cohort study investigated associations between LDL and HbA1C levels with major cardiovascular events, all-cause mortality, and cancer recurrence in patients with breast and prostate cancer. The analysis included 832 breast cancer and 593 prostate cancer patients from the Taipei Medical University Clinical Research Database (2011–2020), using Cox proportional hazard models with time-dependent covariates. The findings were validated using the TriNetX research network, using a propensity score matching method. Results: Elevated LDL levels (≥130 mg/dL) were associated with a higher risk of major cardiovascular events, particularly in prostate cancer patients. A U-shaped association was observed between LDL levels and all-cause mortality, with the lowest risk in the 100–129 mg/dL range (propensity score matching risk ratios for all-cause mortality with LDL ≥130 mg/dL: 1.05 [95 % confidence interval 1.02–1.09] for breast cancer and 1.08 [95 % confidence interval 1.04–1.12] for prostate cancer). Elevated levels of HbA1C (≥6 %) were also associated with increased risks of cardiovascular events, with a potential U-shaped association with mortality. Conclusion: Higher levels of LDL and HbA1C are associated with increased risks of cardiovascular events and all-cause mortality in breast and prostate cancer patients, supporting current cardio-oncologic guidelines in cancer survivors. |
| format | Article |
| id | doaj-art-f5a3c8ea6702471296afa93e983edff3 |
| institution | Kabale University |
| issn | 2772-4875 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj-art-f5a3c8ea6702471296afa93e983edff32025-08-24T05:15:25ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-09-012620046810.1016/j.ijcrp.2025.200468Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patientsYen-Chou Chen0Jhih-Yuan Lu1Chun-Yao Huang2Yu-Hsuan Joni Shao3Division of Cardiology and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, TaiwanOffice of Data Science, Health Data Analytics and Statistics Center, Taipei Medical University, Taipei, TaiwanDivision of Cardiology and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan; Corresponding author. Division of Cardiology and Cardiovascular Research Center, Taipei Medical University Hospital, No. 252, Wuxing St, Xinyi District, Taipei City, Taiwan.Office of Data Science, Health Data Analytics and Statistics Center, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Corresponding author. Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 301 Yuantong Rd, Zhonghe District, New Taipei City, 235, Taiwan.Background: Cardiovascular disease is a major non-cancer cause of morbidity in cancer patients. Low-density lipoprotein cholesterol (LDL) and hemoglobin A1C (HbA1C) are shared risk factors for cancer and cardiovascular disease. However, optimal management for these factors in cancer patients remains unclear. Methods: This retrospective cohort study investigated associations between LDL and HbA1C levels with major cardiovascular events, all-cause mortality, and cancer recurrence in patients with breast and prostate cancer. The analysis included 832 breast cancer and 593 prostate cancer patients from the Taipei Medical University Clinical Research Database (2011–2020), using Cox proportional hazard models with time-dependent covariates. The findings were validated using the TriNetX research network, using a propensity score matching method. Results: Elevated LDL levels (≥130 mg/dL) were associated with a higher risk of major cardiovascular events, particularly in prostate cancer patients. A U-shaped association was observed between LDL levels and all-cause mortality, with the lowest risk in the 100–129 mg/dL range (propensity score matching risk ratios for all-cause mortality with LDL ≥130 mg/dL: 1.05 [95 % confidence interval 1.02–1.09] for breast cancer and 1.08 [95 % confidence interval 1.04–1.12] for prostate cancer). Elevated levels of HbA1C (≥6 %) were also associated with increased risks of cardiovascular events, with a potential U-shaped association with mortality. Conclusion: Higher levels of LDL and HbA1C are associated with increased risks of cardiovascular events and all-cause mortality in breast and prostate cancer patients, supporting current cardio-oncologic guidelines in cancer survivors.http://www.sciencedirect.com/science/article/pii/S2772487525001060Cardio-oncologyLow-density protein cholesterolHemoglobin A1CCancer survivorsCardiovascular disease |
| spellingShingle | Yen-Chou Chen Jhih-Yuan Lu Chun-Yao Huang Yu-Hsuan Joni Shao Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients International Journal of Cardiology. Cardiovascular Risk and Prevention Cardio-oncology Low-density protein cholesterol Hemoglobin A1C Cancer survivors Cardiovascular disease |
| title | Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients |
| title_full | Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients |
| title_fullStr | Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients |
| title_full_unstemmed | Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients |
| title_short | Associations of low-density lipoprotein cholesterol and hemoglobin A1C with cardiovascular events and mortality in breast and prostate cancer patients |
| title_sort | associations of low density lipoprotein cholesterol and hemoglobin a1c with cardiovascular events and mortality in breast and prostate cancer patients |
| topic | Cardio-oncology Low-density protein cholesterol Hemoglobin A1C Cancer survivors Cardiovascular disease |
| url | http://www.sciencedirect.com/science/article/pii/S2772487525001060 |
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