Advanced cardiovascular-kidney-metabolic (CKM) syndrome may be associated with an increased risk of developing cancer, according to findings from a Japanese study published in Circulation: Population Health and Outcomes.
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” said lead study author Hidehiro Kaneko, MD, PhD, Associate Professor in the Department of Cardiovascular Medicine at the University of Tokyo in Japan.
The study authors noted that the findings suggest a need for integrated risk assessment and prevention in multimorbid patients.
Background and Study Methods
Nearly every major organ system can be affected by CKM syndrome; however, the relationship between CKM syndrome and cancer risk has been unclear before now.
Researchers conducted a retrospective cohort study using the DeSC administrative claims database in Japan to analyze patients with CKM syndrome (n = 1,390,901) between April 2014 and August 2023 from health records and insurance claims. A baseline CKM stage (0-4) was defined in alignment with the 2023 American Heart Association guidelines. The researchers assessed cancer incidence as the main endpoint.
Key Findings
Patients with higher baseline CKM syndrome stages had a greater risk for developing cancer. Compared with stage 0, patients with stage 1 CKM syndrome had a hazard ratio (HR) of 1.03 (95% confidence interval [CI] = 0.99–1.08), after adjusting for demographic, clinical, and lifestyle factors; patients with stage 2 CKM syndrome had a hazard ratio of 1.02 (95% CI = 0.99–1.05), those with stage 3 had a hazard ratio of 1.25 (95% CI = 1.21–1.29), and those with stage 4 had a hazard ratio of 1.30 (95% CI = 1.25–1.35) for stage 4.
The association between higher stages of CKM syndrome and increased cancer risk was consistent across cancer types and subgroups, as well as when stratified by age and sex.
Sensivity analyses that used alternate definitions of CKM syndrome supported the robustness of these findings.
“CKM syndrome represents a complex interplay among the cardiovascular, kidney and metabolic systems, where dysfunction in one area may trigger or exacerbate dysfunction in others,” Dr. Kaneko said. “Dysfunction in each of these systems is independently associated with cancer risk due to shared risk factors. This study suggests that the accumulation of risk factors within the framework of CKM syndrome may contribute to the development of various types of cancer.”
“We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease,” said American Heart Association volunteer, Tochukwu Okwuosa, DO, who is Director of Cardio-Oncology Services at Rush University Medical Center in Chicago. “The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk. Consequently, healthy lifestyle choices potentially impact both conditions that are the leading causes of death in the United States. For those with established cardiovascular risk, the CKM syndrome staging framework may be a useful tool to flag high-risk individuals for potential cancer screenings and evaluations.”
The study authors did warn, however, that the results of the Japanese cohort study may not be fully generalizable to other countries, but similar findings have been reported in other studies, making it a possibility that needs to be fully verified.
DISCLOSURES: For full disclosures of the study authors, visit ahajournals.org.
