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Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer.

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Raisi-Estabragh, Zahra  ORCID logo
Cooper, Jackie 
McCracken, Celeste 
Crosbie, Emma J 
Walter, Fiona M 


OBJECTIVES: To evaluate incident cardiovascular outcomes and imaging phenotypes in UK Biobank participants with previous cancer. METHODS: Cancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls. Competing risk regression was used to calculate subdistribution HRs (SHRs) for associations of cancer history with incident CVD (ischaemic heart disease (IHD), non-ischaemic cardiomyopathy (NICM), heart failure (HF), atrial fibrillation/flutter, stroke, pericarditis, venous thromboembolism (VTE)) and mortality outcomes (any CVD, IHD, HF/NICM, stroke, hypertensive disease) over 11.8±1.7 years of prospective follow-up. Linear regression was used to assess associations of cancer history with left ventricular (LV) and left atrial metrics. RESULTS: We studied 18 714 participants (67% women, age: 62 (IQR: 57-66) years, 97% white ethnicities) with cancer history, including 1354 individuals with cardiovascular magnetic resonance. Participants with cancer had high burden of vascular risk factors and prevalent CVDs. Haematological cancer was associated with increased risk of all incident CVDs considered (SHRs: 1.92-3.56), larger chamber volumes, lower ejection fractions, and poorer LV strain. Breast cancer was associated with increased risk of selected CVDs (NICM, HF, pericarditis and VTE; SHRs: 1.34-2.03), HF/NICM death, hypertensive disease death, lower LV ejection fraction, and lower LV global function index. Lung cancer was associated with increased risk of pericarditis, HF, and CVD death. Prostate cancer was linked to increased VTE risk. CONCLUSIONS: Cancer history is linked to increased risk of incident CVDs and adverse cardiac remodelling independent of shared vascular risk factors.


Peer reviewed: True

Acknowledgements: This study was conducted using the UK Biobank resource under access application 2964. We would like to thank all the UK Biobank participants, staff involved with planning, collection and analysis, including core lab analysis of the CMR imaging data.


epidemiology, magnetic resonance imaging, Male, Humans, Female, Prospective Studies, Biological Specimen Banks, Venous Thromboembolism, Heart Failure, Myocardial Ischemia, Stroke Volume, Risk Factors, Atrial Fibrillation, Stroke, Phenotype, Hypertension, Pericarditis, United Kingdom, Neoplasms

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Engineering and Physical Sciences Research Council (EP/P001009/1)
Medical Research Council (MC_PC_21001, MC_PC_21003, MR/L016311/1)
British Heart Foundation (Clinical Research Training Fellowship, FS/17/81/33318)
Horizon 2020 Framework Programme (825903)
National Institute for Health and Care Research (NIHR300650)
NIHR Manchester Biomedical Research Centre (IS-BRC-1215-20007)
Cancer Research UK (CC8640/A23385)
Barts Charity (G-002346)